TRATI ROTI TOU EXPERI TOYO TH b anc 0 ., n low-Took ni cr ity f i t ria 1 2 THE I EMITTED IN P RTI L F LFILLM T OF THE REQUIREME TS FOR TH DEGREE OF MA TER OF EDU ATI IN COUN ELLING UNIVERSITY OF NORHTERN BRITISH COLUMBIA December 2015 © Nancy An low-Tooke, 2015 ll b tra ct Thi tud y care t y uth. 1 red the li ed p n enc f u ing n n-cr ti t uch t dem n trat hermcneuti - phen men 1 gica l appr a h wa u cd to c llect and analyz th e xp ri nee f nin parti ipant wh rk a pr fe i nal in a h lping f c mmuni ca ti n, relati n hi and deci ion-making fac tor em rg d from thi anal i . It a di c v red that whil e the three theme appear to be eparate in a tuality th y c uld n t bee amined in c mpl ete i lati n. o rall e en e f awaren astl y, th e wa prominent thr ugh ut there carch and th e importance of being awa r of multipl e dimen i n within the rea lm f coun e11ing. The li ved experience of the participant i fu rther elucidated through lived c i tenti als to give a compo ite de cripti on of what the exp ri enc i of u ing non-erotic touch to demon trate care to youth . Implication for furth r practi ce and serv ice prov ider organi zati on is explored as well a considerations and recommendation for coun sellor education and future research. Ill T B F T T .. b tra t 11 Li t f 1gure v knowl edg m nt hapter 1 hap ter 2 Chapter 3 Chapter 4 nd dicati n Vl I11tr ducti 11 1 ignifica11 e f R e ear h T piC cfi11i ti 11 fTerm Purp e of the tud and R arch 11te t R c earcher nceptua l en fVl w fth he i 1 2 u ti n 4 7 Lit rature Review ommuni cation B enefic ial Primiti ve Expli cit and Mutual Self- ware R elation hip 24 29 M ethodology 36 Qualitative Introduction Specific Qualitative M ethodolo gy R esearch Procedures Ethical Concerns Data A11alysi Evaluative Criteria Evaluation of the Study Summary 36 36 39 41 42 44 47 4 R esearch Findings 49 Figure 1 Self-Awarene s C lient Focused Awareness Communication R elation hip 51 52 53 54 60 10 12 15 18 lV ecJ 70 n Making 85 hapter 5 ther (Relati nali ) ( r ality patiali ty emp rali ty) hapt r i n and 10 109 onclu 1 n Reminati n fth e iterature Limi tati n of the tud Impli ati n ~ r Further Practi e Impli cation ~ r ervi ce Pr ider rgani za ti n un ell r on id erati n and Rec mmendati n ~ r du cation n iderati on and Reco mmendati n for Future Re earch P r nal Refl ecti n Reference Appendix A: Re eareh Participant In~ rmati n Letter and 10 11 8 120 122 123 l 23 126 12 9 on ent Form 134 Appendix B: Re earch Participant on ent Form 137 Appendix C: Community Re ource Li t 138 v i t of Figur 1gur 1 The mbr lla 51 VI knowl d em ent and D dication Th r are a numb r f p and upp rt thi th inda i ma n t ha that eill wh Her g ntle guidan m I am ap r eing t nd . Th nk iativ that with ut the ir guidan c r. me t fruiti n. I am thankful t m riting a th , enthu ia m and pati n writing throu gh t th ~ r agr plc t ut r. 1 , a r gi nal tud nt, w d abl . thi ere aram unt in being abl e t rinnc K hn and r. berry cau nt the i fr m a di tance and taking n th e hall cng a ociated with w rking fr m a far. I am thankful to every ne f my parti cipant wh were willing t hare their e peri n e ofu ing touch in daily prac tice with y uth . Y our caring way arc definitely an a et t th y uth u work with a well a to the c mmuniti e y u erv e. Marianne Hemmy our unday m rning kypc date ver coffee kept my head abo ve water. You are definitely a fabulou cheerl ader. Thank you for your in ight into my topic as well a our di cu ion about what my re earch revealed. I have a mountain of gratitude for my dear fri end , Rachel Mulder, who kept me focused , accountable and propelled m y forward morn ntum particularly wh n I felt I wa slipping backward. I cannot thank you enough for constantly in pirin g me to sta y cormnitted to my decision to write . I would not have been able to fini sh this th es i without your support. Thank you. Lastly, I dedicate thi s thesis to my family . My two sons, Josh and Sam, and my husband, John, have spent nurnerou evenings and weekend without me so that I could pursue this dream. John, your unwavering upport and encouragem ent means more than you will know . 1 hapter On : Introduction fh aling th t dat T uch ha b en u d a a m th (H rt n Ian m h ff, 1 , tcrk- lif: n acup un ture t uch i u cd t pr 5 . H w n (H therington, 199 ; Kertay pre er, he eliminated t uch th c ncept actua lized and criticized th hinc c m ti nal rca ti n and diagn id th u e of non-er tic t u h t facilitat em ti nal L e, 19 O· Phelan 20 fyear r e amp le, in la ical reud d cum nt in hi early p pati nt ' alim nt p ych therap entire! ba k th u and 1 c ch therapy pra ticc n ( urana, 19 · H lub ' ithin the rea lm f f tran ference and countertran fcrence were e who c ntinued the practi ce f t uch in th erapy Reviere 1 93 , beli eving any type oft uch would certainly lead to e ual r lation . Freud ' change in opinion and practi ce contributed to touch becoming taboo ( quino & Le 2000; Ph elan 2009). Hi opinion wa th e cataly t that cau ed touch to be rarely spoken of even though orne practitioner continued th e use of non-erotic touch in their practice. Freud ' later beli ef that touch be trictly prohibited was extremely influential in many etting where the u e of non-erotic touch became strictly forbi dd en between practitioners and clients even though touch is the earli est and most basic form of human communication and influences human development (Wil on, 1982). Significance of Research Topic Today touch continues to be a sensitive subject despite its known positive effect , for fear that oth ers will think it is sexual (Durana, 1998; Kertay & Revi ere, 1993 ; Toronto, 2001 ). However, the traditional rule of ' never touch ' is being cha llenged, as it i evident that more and more counsell ors are using touch with clients (Wes tl and, 2011). 2 Int re tingly t uch i not n ugh fa tab n vertbel t p u ing it a a t th fear i great en ugh to pr nt di u ing it ( un elling technique ; nitz 200 ; H rt n , lance, t rk- lif n t u h i n t :D r e e 1o ry ne it i imp rtant that the u talked ab ut in ord r t rem vital on thi topic to in r a an [! ar and ti gma d ; that it be nto, 20 1). M re awarene und r tanding and impr ve th accura y f interpretin g it intent ( t nzel & Rupert, 2004 . Tran par nc i tally imp rtant a di cu sing the u e oft uch with eli nt , coun ell r awarcne , and en urin g t uch i utili zed t meet the need of only th client (Hort net al., 1995 ). Definition of Term There are everal type of touch to con idcr in a coun ellin g environm ent. exual touch and touch u ed for phy ical puni hment are unethi ca l, often ill ega l, and go again t a multitude of ethical guideline (Aquino & Lee, 2000). The Briti h Association of Clinical Coun ellor (2009), the Canadian olumbia ounselling and Psychotherapy Association (2007), the Canadian P ychological A ociation (2000), and the ollege of Psychologists of British Columbia (2009) all clearly tate in their codes of ethic that counsellors and psychologists are not to engage in sexual relation hips with clients. Amongst these governing bodies , ethical principles are addressed in detail making it very clear that any sexual relations between counsellor and client is unacceptable and will not be tolerated. While the topic of touch is sensitive and often elicit thoughts of ex and sexuality, for the purposes of this thesis , I am strictly referring to non-erotic touch . Nonerotic touch can best be defmed by examining the meanings of erotic and touch. According to The World Book Dictionary (2005), erotic is defined as, "1. of or having to 3 do with e ual pa ion r lo ubj ct t ; 2. ar u mg r tending t ar u e tr ng e ual de ir ". ther part f the b d ou h i defin d a , " 1. t put th hand , fin ger, r n r again t and feel · and 2. t put make conta t with." With th help f the a making c nta t again tan ther p r n that i n t h i t u bing n r th t u hed . Purpo e of the tud y and R f arch Qu touch practice ( quin e pen enc L n thing) gain t another; ual , pa i nate, r ar u ing t tion me th rapt t t c mplet ly rem realm of coun elling, it cl arl h m definiti n , n n-eroti t u h can b d cribe neither the n e pit the ef~ rt ual de ir ; and . e the u e of t uch fr m the benefit , an d practitioner are engaging inn n-croti c , 2000 . The purp of tho e in the helping pr fe i n wh e f thi tudy i t understand th e boo e t engage inn n-er ti c t uch a a mean to demon trate care to client . The literature, whi ch i f-u rther di cussed in th e literature review , outline the benefit of non -eroti c touch working as a profe si nal helper, and addre se the trepidation over choo ing uch technique in practice. thical concern and con ideration are not clearly defined in the literature and need further clarification. The deci ion to utilize thi technique to demon trate care will al o be examined . In this study I hope to gain a greater understanding of how profess ional arrive at the decision to utilize touch and understand any ethics helpin g to guide this choice. The question guiding this research is: What is the experience of using non-erotic touch to demonstrate care in professional helping practice with youth? A econdary question is : What factors influence your deci ion to engage in non -erotic touch or not? Re earcher onte t f t u h. It i r gard ing th u Within 1 u , 111 m a n t u h p li h initiating hu g hug m 1 di tri t, th r i a 1 k f 1 r, lini h W rking fl r th adult u ing t u h w1th tud nt n m tudent ~ l be tter. rl dem n tr t 1tne. d. d adult th n h ~ 1tn mg f r m r c n r te, uch a in ten t, Inill atJ n, ll mmg and the imp rtance b rva tJ n fad who that i r gul arl br k n. I ting the n d f th adult t ma k th t addr addre pini n, that t u h n ed t h1 h I be ll v I n t wa rd b und ry v1 1ati n du e t th e ith tud nt , thi al prin ipl 1, nd thi a1 guid lin f th u f t u h al peak t the i ue f n d ar b ing met dunng u h in id n I w rked ith a tud ent wh regul ar! r ached ut and t u hed me. 11c would eith er u e hi fing r to t uch m n and on occa ion gi e, pat my arm r h ulder with hi hand , hare a hi gh fi ve me a hug. Th e more I read ab ut th e u e of t uch in prac ti ce, th e more I under tood tudent' need to touch and hi n ed t fee l gr unded and accepted. I wa no longer troubl ed by thi touch , and con idered it acceptabl e becau e I had a greater under tanding that touch on th e forearm or a hi gh fi ve in thi in tance wa not a boundary cro ing or violation. I al o perce ived thi touch a meeting th e tudent ' need , not my own a he initiated th e touch . My relationship va tly improved with thi tudent once I became les ri gid and more relaxed regarding th e u e of touch. He wa more attentive, mor hone t, and made ome very profound tat m nt elf-awarene b ut hi own urrounding hi behaviour. I topped panicking with thought of who wa watching or what wo uld they th ink when tudent reached out t hug me. Previou ly , I beli eved touching tudent wa 5 wr ng r gardle a tudent w I ha of th cir urn tan a gr at r und r tanding that m eting need i not t b :D ar d, but embra ed. Kn w mg m intent wh en u ing touch with a tud nt i t me t hi r ater elf-a warcn r h r need regarding int nt and und er tanding f wh ha al o r in£ r ed the importan relation hip . n th I feel m rc r 1 cd wh n u h incident an c. f de need are being met 1 ping a tr ng, tru ting, and therapeuti c ther hand , the imp rtanc f my c lf-awa rcne regarding my alue beli ef: thought , and a ti n ha b en reaffirmed and rei n£ rce thi i a c n tant proce I mu t engage in. H we cr, a a profc i nal I wi ll n t have free reign t touch lient at any given moment . Wh at it mea n to me i once a trong, tru ting th erapeutic relation hip ha deve l ped, in£ rmed c n ent ha been btaincd includ ing th e u c of touch, and th benefit of thi touch £ r the client arc explored, then it i can be incorp orated into my practi ce. I under tand th re i om ethin g that orn e work to be done on my part in regards to being ab olutely certain what my boundari c surrounding touch arc and how I will chao e to u e it to benefi t my client . If there is one thing I have learned, it is that I no longer have a sense of wrong do ing when I give a youth reassurance through a touch on hi s or her shoulder, placin g my hand on hi s or her arm to help him or her refocus, or by giving encouragement with a hi gh five . I now have a clearer appreciation that touch is not a cause fo r alarm when it is u ed fo r all the ri ght reasons with the intent of benefi cence, while also having an acute awareness of nonmaleficence. W orking with children and youth for th e past twenty plus years , l have always been told that I am not to touch them, regard less of the circumstances. Na turally all sorts of circumstances arise and when thi ru le was challenged I eemed to get the ame respon e, a ible. Wh n I id t u h a mu h a p ho le-heartedly . the ung rand m r nai" e, It a b ar pre ed n and m ontinu d thi n -t u h p li y and if I wa r all k thi advi ame m re prolific, I tu k and c uld n t a id a hug D r ample I would rai e n hand hi gh int the air and recipr cat w ith what I call a half hu g. ll the e year , I ha e had c nfli ting fee ling . I tud ent I ha cr d path 1 w in m heart that ith trul did need that phy i al me f the ntact they were d perately eeking ut. I ft n que ti n d " h t i the harm ?" when I heard co ll eague c mm ent n their n d t know what i go ing on in a tud ent ' n the ther hand, life so they knew wh n t gi e him r h r a hug r n t, it did n t it well w ith m e. I could clearly D el th e di tincti n yet I did n t under tand it. Wh en I began to read int the u e of touch, it wa like an epiph any D r me. I wa beginning to under tan d. I tarted to under tand the clear di tinction between meeting the tudent ' need and m eeting my own . I was aware of wh y tho e no touch poli cie were in pl ace; fea r. There is an enduring a ociation between the word touch and sex. Wh en I began to und erstand some of the negati ve background regarding th e rea ons to avo id the use of touch, I al o realized there are many positive benefits to the use of touch . Conceptual Lens Albert Einstein has been quoted as saying, "Everything that can be counted does not necessarily count; everything that count cannot necessarily be counted" (Harris, 1995, p.3) . This quote is indicative of the importance of qualitative inquiry for this study. Examining non-erotic touch caru1ot be counted yet people's experi ences are meaningfu l and they do count (Mayan, 2009) . Through interpreti st m ethods and a henneneuti c phenomenology framework, the essence of peop le' experi ence regardin g non-ero tic 7 t uch within an du ati nal t uch b tween p opl a human int racti n the u h an be a n iti t pi and I rm n uti ph n men 1 gy i there[! r h n m n 1 g1 al fram w rk all wed D r human e p ri n e thr ugh interpr ting parti ipant' ith th r and d e pen nc unter. 11 he henncn uti well uited t thi r cl are aminati 11 f th amm d. tting w (Tan, Wil n ing th phen men n f t uch t rc ca l th c cnc n, li r 2 0 ). Th h pe i that thi pr cc f will r ate m aning and under tanding r garding th u c f n n-cr ti t uch a well a th e dcci i n t u t u h r n t (La rty, 200 . Overview of th T h hapter on introduce the t p1c f u ing non-er ti c t uch and c tab li he the rational e behind thi r ear h and the primary que ti n guidin g thi tudy . Bri ef definition of non-ero tic touch ha ve been pro ided to elucidate that touch which i clearly illegal or unethical will not be exa mined. M y per onal experi ence have been recognized . I conducted thi re earch u ing an interpretive henn eneuti c phenomenology framework to capture the essence of the experience , and further comprehend the decision to use non-erotic touch , of tho e working with youth. Chapter two provides a comprehensive literature review of research regarding the use of non-erotic touch within a therapeutic setting. It begins with discussin g the importance of communication, the benefits of touch for clients, and the primitive nature of touch. Ethics is then reviewed focu ing on the importance of being explicit regarding the use of touch, mutual agreement, and the importance of clear, well-d efin ed boundaries. Finally the importance of the therapeutic relationship is recogni zed. 8 hapt r three pr id a det il d utlin ph n men l gy fram w rk ~ r thi r p cific re car h pr edure are pr and intervi ew tru tur f the int rpreti ar h. thi al n hem1eneuti rn and i ue ar addre ed. id d including re ruitment f parti ipant , on ent, de cripti n f all pha e and pre entati n provid d along with h w th hapt r four anal ze m r f data arc tud wa e aluat d. arch findin g that re ea l the crall en c fth e participant ' e p ri n e regarding the ph en m na f u ing n n-er tic t uch t dem n trat care a b mg awarcne . Th main theme of c mmuni ati n, relati n hip and dcci ion making fac tor area l The li ved e i tcntial f li c amined. d e pen cnce are e amined in chapter fi ve . The th em es or existential of the experience of u ing non-er tic touch are li ved relati on, lived b dy, lived pace and lived tim . It i through th e interprctati n of each of th e ex istenti al that the true es ence of th experi ence i revealed. La tly in chapter ix, a com pari on of my re earch finding to the literature is mad e. There is discussion reflecting on limitations to thi s re earch a well impli cati ons for furth er practi ce and servi ce provider organi zations. Consideration and recon1mendations for counsellor education and future research are also examined. The chapter concludes with my personal refl ections. hapt r Two: hapt r tw pr it ratur R v i w f th lit rature ab ut h w th e u c of ide a c mprehen i e r non- r tic t u h can b u ed t d m n tratc ar t It b gin with an intr du ti n t hat p ddr me in ight mt h w di ffi ult defining ed . M r d tai l ab ut the u , mul tiface ted natur the imp rtan e f u ing t uch hile till [! 11 wing pr fe d veloped, ti f n n- r tic to u h arc f t u ch , it ben efi t D r li ent , and e plor d ba cd n th remainder of the chapter fo u c t1ing . n ider d n n- r ti and t u appr priate t u e und r the right cir urn t nee. nb ard li nt in a therapeuti i na l, eth ical guideline . T he n h w the therapeutic relation h ip , when fu lly rything t ge th ra nd thu au thenticate h w th e u e f n n-cr ti c touch demon trate care. Th e chapter c nclude w ith h wa ll the e element oft uch sub tanti at that the u e of n n-erotic t uch d m n trate care. R e earch ha indicated th at the u of non-eroti c t u ch to demon tratc care ha been a long-standing topi c of deb ate (Kertay & R ev ier , 1993) . M any therapi t have concern s that touch i con idered taboo (Bonitz 200 8; Durana, 1998 ; Gc ib , 1998 ; K crtay & Reviere, 1993 ). However, tudies also reveal that although touch i compl ex and multifaceted, therapi sts are utili zing touch in the th erapeutic setting (F o shage, 2000 ; Geib , 1998). The u se of touch can b e beneficial to many clients in a variety of way including enhancing communication, as well as reinforcing and reestabli shing th e mother-infant bond (Toronto , 200 1) . The ben fit of touch can fo ster th e therapeutic relationship b etween therapist and client, and when choosing to utilize touch wi th in practice, one cannot forget the importance of following ethical guideline . 10 ommunication r t u hi Powerful and intimat conn ction . " mmun1 bl mn th rrymg man m ag rp rat T u h in n n rbal upl 2 a numb r f fa nn . It pr 2 01 ) it uran 200 ; mmun1 atJ n , and \ h n 19 mu h m r than rd ( nitz, 2 u ( urana, 1 ti n th r ugh th un nd what w rd pr rbal it a ur n , 1 ; W tl nd , 2 11 , Jt 1 a p w rful [! n11 bin , 1 t nl mmuni ca t1 n. in t n11 e ,2 a t an intimat barri r , ' Wil n, 1 2 p.65 . an qum n e nitL, e ,2 mmum atJ n fa d , t u h can c mmuni ca te ib, I ; Kerta Rev1er , 19 2001 ). f n n- r ti t uch ca n b v ry p werful ( hage , k upl echin , I 4) by mmuni ati on with a non- erbal mean ( nitz, 200 ). cc rding t mmuni cating with the u 2000) . It trengthen upporting rbal upp rt pr id d t cli ent (Halbr We tland (2011 ) it m aning can be multifaceted fac ilitatin g a more open and intim ate relati on hip between client and th erapi t (Durana, 199 ). A eib ( 199 ) de cribe , th e u e of touch prov ide a deeper th erapeutic e perience when language i n t enough. It provide a more profound, more intense experi ence for th e cli ent yet cond en ed in contra t to verbal communication. We tl and (20 11 ) agree th at through th e u e of noneroti c touch a deeper intimacy i achi eved in compari on to tri ctl y verba l communi cati on. Kertay and Rev iere (1993) expl ain th e kin provide am re elab rate fonn of communication in term of the developin g a en e of elf. Durana ( 199 ) and Fo hage (2000) agree that non-erotic t uch enhance elf- di clo ure, which a! contribute to a deeper intimacy within th e therapeuti c etting. In addi tion, Hort on tal. 11 (19 5) believ a d per intima y i a hi f a-D ty -D r the eli nt t hag ( urana 199 · F p r e pl r ti n f D ling . tabli h an empath tic 2 elop ( urana , 1 t m( mal in , 1 · H rt n t al., 1 200 ). Halbro k and nnecti n 7 . It can c mmum ate a ceptan e 5; K rtay Re iere, 1 ), and all w that n n- crbal c mmuni ati n cannot through ib, l 9 ) with m e age that the th crapi t i genuin e and authenti , and the li nt i not nl w rth m all w D r d p nu ( o hage 2000; Kup-D rmann incr a ing elf- ntributing to a d eper en e n-er ti t u h can help t onn ection. tru t to d ed due t t u h upl f uch feeling , but al able ( nitz, bin (2004) validate thi , tating that t uch can convey age of valu and w rth to the eli nt. quin and Lee (2000) go that an ab ence of touch can ugge t a lack f w rth . far a to tate everthcle , the implication of a client ' value and worth can be rea suring, and reduce hame (Durana, 1998) . A s cib (1998) describes it, using touch provides a new approach to relating, which can be an effective means to communicate when verbal communication break down (Bonitz, 2008). The use of touch complements verbal communication a it reach a level of understanding beyond what words can convey (Toronto , 2001) which allows one to be fully human. It is very evident that the use of non-erotic touch provide a means for communicating that is on a different plane in comparison to verbal communication. Not only does it communicate on an unconsciou level, it add a further dimension to facilitate therapi st understanding as well as a powerful mean to communicate a number of positive values including acceptance, va lue, and worth in addition to providing the client with a sense of being loveable. 12 Beneficial Th lit ratur and u n thing cry 1 ar in r gard qu nt re ar h a ai labl mak t the u e of n n-cr tic tou h in the th crap utic r alm, and that i it p tenti al benefit . Th u f n n- r ti t u h a an adj un t t talk th rap can enhance th rap euti out orne ( urana , 199 · F 1990· K erta & R hag , 2 ; Halbr i re, 1 9 ; Kup ferm ann corre ti e, n edu ati e r 1 ( urana, 1 Revi er ; Kup ~ rm ann 19 healing (Bonitz, 200 ; maldin , 1 k ee upl echin, 1 4 ; H lub ,1 n , J 982) , provid e a age, 2 0 7; W il ci b; 19 8; K ertay 7; T r nt , 20 1), a well a allow ~ r urana, 199 · Kup fe nnann mald ino, 19 7). E nhancin g therap eutic outcom e . T he u e f n n-er tic touch ca n enh ance therap eutic outcome in a number of way . Fo hage (2 000) explored how tou ch can help a client tol rate pain , whi ch in tum aid in fac ilitating treatm ent. It all ows the cli ent to reach out wh n in pain rath er than w ithdraw ( eib , 1998). It all ows th e cli ent to not only fac e their pain but al o to tolerate the pain enough to be able to work through hi or her i u e more quickly and on a more profound leve l. It can contribute to patient growth and thus improve treatment outcom es (Kupfermann & Smaldino, 1987). Aquino and Lee (2000) researched how the use of non-erotic touch in children provided therap eutic benefits as w ell as helping to relieve di stress, whi ch thus contributed to positive changes in behaviour. Halbrook and Duplechin (1 994) found imilar result . With the use of touch, there was a direct relationship to th e increa e in elf- di losure from cli ents, which resulted in th e clients relating more infon11ati on to their therapi st (Bonitz, 200 8), subsequently outcomes of therapy are improved . Clien ts report that significant therapeutic gains were achieved becau c the therapi t used touch in sc ion 13 ( qumo L , 2000 ; uran 1 Thr ugh the u e oft uch , an in r a 1mpr ; Kupfem1ann in th le maldin 19 7; Wil n , 19 2). 1 f tru t in the th rapi t, a well d quality ofth th rapi t - eli nt b nd re ult din a m re enri ched th rapeutic relation hip . licnt ho e p n n t u h engage in deep r lf-e pl rati n and 1 ( urana, 1 e, 1 · H lub 0. e aluat d their e p n en m r p iti lf-di 1 ur , hi h pr id d a en c f rca uran e in the cli ent, and enhan d perception of th rapi t c mpetcn e and tru tw rth inc Revi ere 199 u h were enh anced K crtay r nt (2 00 1) ~ und in her o n pra ti ce th at touch could move treatment along by breaking th rough tand till , all w in g eli nt t endure intcn c di tre that oft n a c mpanied th und r tanding f earl y rcvc lati n . Touch may alleviate ham e a well a h lp the eli nt tolerate pain enough to face and work through i ue more quickly, or on a deeper level (H rton et al. , 1995) . During peri od of severe distre , such a when a cli ent i fac ing grief and traum a, a well a fo r general emoti onal support, rea surance and caring, non-erotic touch is recomm ended. It can a l o form the ba i for a continuation of analytic work to occur when talkin g alone doe not produce the sought after effect, acting as though it di sol ve th e client ' resistance. It decreases shame that interferes with working through a client 's concerns on a more in ightfulleve l, by providing encouragement and acknowledgement by enhancing feelings of worthiness (Durana, 1998). Similarly, Kertay and Reviere (199 3) found that touch was benefi cial for highlighting verbal statements, engaging a cli ent' attenti veness, and contributing to blocked clients being rejuvenated. Fosshage (2000) di scovers that not only doe the usc of non-erotic touch enhance therapeutic outcom es, it is also neces ary fo r phys iological system s to remain healthy . He found that the use of touch could stimulate th e brain to 14 pr du nd rphin that 1 w r h art rate a non-er tic t uch an b u ed in a ri i d pre ur . ll a bl ituati n t c f~ ti el w 11 th u ntr l th ympt m f f Re 1er 1 ). In general, the in linati n for therapi t t u e t uch can 1 ad t benefi ial ut m t anxiety and c mmum ate upp rt K rta harm t the li cnt appear t cau t, y t at w r tit d c not hen u d appr pri t ly (Kcrtay orrecti ve and edu cativ b n fit. Rc iere, 1 9 ). f n n-cr ti c t uch t d m n tratc arc h u can ha e a rre ti e, educati nal r l within the therapeutic rea lm . (2000) beli e the id ea that t u h an b reparati quino and ce i a ery p werful tenet. They belie e that it may c rr ct dcfi it in parental experi ence all wing children to be taught beneficial form f touch, enc urage appr pr1ate e pre Ion f emotion , and beco me educated on h althy child -adult boundari c . eib ( 199 ) concur that with th e u c of touch, client learn that phy ical contact d e not equ ate to exuali ty, allowing cli ents to learn about healthy emotional and phy ical relation hips with oth er . Touch within th erapy can provide a afe nurturing corrective emotional experience that enhance se lfexploration as well as emotional expres ion (Durana, 1998). Touch, including hugging and holding, bas been helpful as part of repairing early damage in the cli ent' experi ence (Kertay & Reviere, 1993). One cannot fail to acknowledge that the touch itself is in some circumstances the restorative stratagem (Toronto, 2001 ). Hea lin g. Touch has been associated with healing across many cultures (Aquino & Lee, 2000). Not only has it had a significant role in healing practices, it is prevalent in religious observances as well (Bonitz, 2008). Durana (1998) also writes about th e u e of touch being prevalent in many fonns of hea ling dating back thou ands of years includ ing healing for psychotherapeutic reason . Kupfermann and Smaldino (1 987) write about the 15 tr ng maturati nal f£ t f t uch wh n u ed £ r p r alue, all wing £ r de el pm ntal gain . The u awarcn fbi Fr m a ph i logical p r p lowering blo d pr r h r b dy r a de el pment fbi ti t uch can nality gr f t u h pr id the lient with an r her bod £ u mmuni at ur and h art rat during time th rath r than plea ure f durc urana 199 ). en f upp rt thu ( age 2 00 . Primitive Touch can al be con idered a primiti e need th t tart in ne' infa ncy in term normal de cl pm nt and th £ rmati n f appr priate attachment . f ouch i al o an imperati c clement fa hea lthy m th er-child bond, and can be ymboli c of m th ering . Finally, caring touch pro ide indi idual with a en e of we ll being and nurturance. N urturin g tou ch. Th impact of touch on ne ' devel pm cnt date back evcral decade according to Kupferm ann and maldin (1 9 7) when Harl w (1957, 1958) studi ed rh e u m onkey and di scovered phy ical contac t between infant and the ir mothers is crucial for th e healthy development of infa nt . Harlow' tudics reiterate th at touch i one of the most important en e . Nurturing touch not only pl ays an intricate role in healthy human development, it is es enti al to the healthy deve lopment of a child (Aquino & Lee, 2000 ; W estland, 2011 ). Encouraging phy ical contact i important fo r the development and maintenance of phys iological and psychological regulation and th e type of physical contact pivotally affects behavioural development. Studies of mammal, primate and human behaviours clearly demonstrate that touch is a basic behavioural need, and when the need for nurturing touch rem ains unfu lfi ll ed, abnormal behaviour wi ll result (Fosshage, 2000) . Bonitz (2008) state that touch deprivation in infancy has been linked not only to an infant failure to thri ve but also to 16 aggre i c b ha i ur in adult . urana (1 9 ) agree in hi r arch that t uch i 1 pm nt. h m a ure f the mo t imp rtant en e · it i criti al to human de ne f I e' de l pm nt can b e aluated thr u gh th e ability of th e indi idual t enj y g i ing an rc iving ph i al nurturing, thu rein~ rcing the imporianc rclati n hip during infan ater re arch u gg a f t u h in interp er na l ell a later in li fe. t that n t onl i nurturing t uch ritical t an infant ' h ealthy de elopm nt · ala k of health t uch ma be re p n ibl e £ ran infant' failur to thrive (H lub Lee 1990 . T u h i more hi gh! de el pcd at birth than th e th er en e ; thcr fore it i th through th e n c that human infant mo t depend upon ~ r c m[i rt and love. It i n e oft uch that the kin mmunicate much of the inc mmg mcs age that are re p n ible for the accumulation of under tanding one e lf (Kertay & R eviere, 1993) . Toronto (200 1) reiterate in her re earch the ignificancc of am ther's lov ing, soothing touch and how it naturally h eightened and enrich ed an infant' deve lopment. A ttachm ent and health y relation hip . B o th Duran a (1998) and Fo ha ge (2000) reference Bowlby 's work on attachment, which explains the n eces ity of touch for a baby , and the fundamental n eed for tactile timulation for healthy relationships. In term of bonding with others , infants who are stroked at the earliest stages of po tnatallife do much better physically, emotionally, and interpersonally in comparison to tho e w ho do not get this type of touch experience. Touch as the earliest form of interaction in an infant's life impacts infant development of attachment patten1 in tem1s of parental bonding and the world as a whole (Bonitz, 2008; Kertay and Revi ere, 1992). In term of therapy, a client deprived of touch during development would exp erienc e signifi cant delays or th e in ab ili ty to bond appropriate with other (Holbrook & Duplechin, 1994 ); 17 therefore £ r a lient h d e n t ha from whi h he r he uld e pl r th facilitating d el pm nt t all d 1 ped atta hment patt rn rld, ph creat a en Durana (19 cure ba e i al tou h c n b a p w rful mean him r her t attain health attachment ( There i n d ubt that th m ther' and father' ph h lding and uddling ra f nitz 2 0 ). ical t uch p rhap in the D nn f f their hild i n t nl vi tall imp rtant fi r urvi al, it al of intimae , 1 c, afety and well-being ( o hag , 2 refi renee arlo ' a wire m ther monke with fi tud d, and a 0) . In fact, f infant m nke that gi en a boice between ire m thcr m nkey ercd in t rry cl th, the infant monkey w uld cuddl th terry cloth m ther leaving nly t feed fr m the mother with th food· the c n lu i n i that the intimacy f phy ical c ntact wa m re imp rtant than feeding. Toronto (200 1) explain , there i a tage of nc' development wherein phy ical contact i crucial, a connection to the one who i providing life- u taining touch. The ignificance ofthi for the therapeutic relation hip is fundamental. Utilizing touch within the therapeutic realm ha a number of important functions according to Mintz a referenced by Bonitz (2008), Durana (199 ) and Kupfennann and maldino (1987). The e functions support the ability for touch to express acceptance and worthiness when a client is overcome with feelings of unworthiness , supplying figurative nurturing when the client is not able to communicate verbally and helping a client establish a connection with his or her external existence when overwhelmed by anxiety. N urturance. Toronto (2001) further explores the importance ofthe mother-child bond and the importance of recreating it in the therapeutic setting. Toronto asserts that it is this type of bond that allows a client to have the kind of profound change or growth he or she is seeking and finally allows him or her to develop fully , thu allowing a client to 18 c ntinu n t li a full life. It i thr ugh phy i al th n ce ity f ph t uch provide p rien ed betw n m th rand infant. c ntact and th m um ati n thi i al t u h imilar t the t u h arl m th r-child intera ti n lo k pe ificall at th r le of attachment and nurturance and cmpath w ithin the contc t f that atta hment b th in th e carl hi t ry f a c lient and w ithin th e fr m ew rk f th e therap eutic relati n hip . ithin th e c nt t f an in i idua l' need for nurturancc and upport, tou h can be icwed a b th ital and n n-cr ti c ( eib , 199 ). Explicit and M utu al Be~ r utilizing n n-croti c t u h, it i e cnti al nd ethica l ~ r the th crapi t to p cnly di cus the u e of tou ch to en ure it i ba ed on b th the cli ent and coun ell or leve l of comfort th ere i cl ear awarene f who e need arc being m et, and th a t bound ari c arc clear, mutually agreed upon and develop ed out of awarene s and opcnn e . Discu ssing touch. It i agreed amon g many rc earchers that th e u e of touch needs to be di cu ed with cli ent prior to the initial touchin g (Durana 1998; G cib , 199 8; Horton et al, 1995 ; K ertay & R eviere, 1993 ; W e tland, 2011 ). It is not enough to j ust talk abo ut touch, but th e coun ell or must be clear from th e beginning of th e th erapeuti c contract about why touch is or isn ' t being included in treatment (W estl and, 2011 ), the boundari es of the therapeutic relationship (Kertay & R evi ere, 1993 ), and to clearly con1municate th at the cli ent has the right to control th e occurrence of touch (G eib , 1998). Together th e counsellor's and the client's p ersonal style, preferences, and exp ectati ons of therapy must be negotiated particularly surrounding th e u se of touch, and must be agreed upon as part of infonned consent (Horton et al, 1995). It is cn1cia l that there al o b e an explorati on of possible sexual feeling that may be arou ed (G eib , 1998; K ertay & R cvicre, 1993). It is 19 the therapi t r pon ibility t initiate the di u i n un unding th u e f t uch, parti ularly in t nn f th ng ing r lation hip (W e tl and 2011 ). M eanin g of tou ch. T r nt b a hand hak , a pat nth 2001 ) tate in e h uld r ry in tan t u h i u ed whether it r a qui k hug th meaning mu t b e pl red t avoid any emb lli hment a t their meaning. W ith ut a king a cli ent b ut th ignifican e h r he take fr m phy ical c nta t, the c un ellor can nly p culate it importanc . Kertay and R vier ( 1 9 ) add t thi touch be pr ce not nly h uld every ccunence f d, it i appr priate t a k the li ent D r penni ion or tat the intention to tou h before d ing o. Bon itz (200 ) confinn the imp rtance fa king the cli ent fo r permi ion b fore utili zing touch w ithin the therap utic etting. urana ( 199 ) i lll agreement that obtaining permi ion i compu l ory pri r t any phy ical contac t. Di cu ion hould not be confined to a ingle exploration of the issue, but should be ongoing particularly when either th e client or the th erapi st change hi or her behaviour; whether thi s means m ore, les , or a di fferent kind of touch (Geib , 1998). Cli ents need help recognizing the need for touch , its ori gin, and th e res istances sunounding it. Communication and questioning between counsellor and client are vital in assessing a client's responses to touch (Durana, 1998). Aquino and Lee (2000) argue that part of th e initial informed consent between counsellor and client must explain the framework for the u se of touch, and clarify clinical justification for the technique. Both parti es must mutually agree upon it. W estland (20 11) argues that social forms of touching such as handshakes and hugs prior to and at the end of sessions are to be avoided. It is more suitable in the actual session where they can be discussed. Toronto (2001) di scu se a client for whom the 20 phy ical t u hal ng with erbal pr a hie e mg fth t u h r ult din h r b ing abl e t 1 ng-term hang . If th t u h ha alread taken pla e, the e pl rati n of the impul pro oked by th t u h it lf and the cli ent' idea b ut h w the , the feeling un ell r will feel ha e t b tak n int delib rati n talked about in relati n to ther feeling , memori e , fanta ie and e ent in th eli nt' li :D . h ha e t be a e ed ( Re ult iti fee dbac k f t uch in e i n i dire tly upp rt findin g that li nt' p corr lated t it c ngru n , li nt r nt , 2001 ). ntr I, and the li ent' abili ty to peak openly w ith the c un ellor (Horton t al 199 . ib (199 ) di cu e the re ul t when cli ent are t uched in e ion and the coun ellor doe not check in to a e eli nt the meaning of th e touch for th em. For the e limit of th th rap euti c relation hip were never reviewed, the cli ents did not have a chance to e plore th eir own feeling , and they were left fee ling un afe. These client felt angry becau e they did not feel comfortable bringing up negati ve or ambivalent feelings . They were also angry becau e the therapi st did not ask what th e touch meant to them ; it was not mutually agreed upon. Client's need and comfort level. It i important that touch is neither unwarranted nor unjust, but an authentic reaction to the cli ent' s explicit or unmi stakable need for phys ical contact (Horton et al, 1995). However, Holub and Lee (1990) reference Mintz who suggests that any client who asserts himself or herself enough to ask for physical contact is probably strong enough to have his or her needs met in relationship outsid e of therapy. A client' s needs and well being, however, are ofutmost importance, as is th e meaning of touch itself for each individual client (Kupfermann & Smaldino, 1987) . Geib ( 199 ) 21 m t a f~ t th ub tantiall . Th th r pi t mu t pr 111 ntr rath r than th th rapi t. u c the th rap uti rclati n hip 111 t rm r lati n hip rath r than and m ti nal intima Jd th t p1 . nt t li nt [! cl h r h rl r p nding t th un 11 r mu t he i a1 m c f ph h r th f th th rap1 t. It 1 n lint' n d rath rthanth n nl di id an 11 1r nm nt ut urag d that th anal f b undanc and limtt a tl , th thcrap1 t i t within th thcr p utic r latJ n h1p pr grc t f the n ur that the phy i al at th amc pace rather than being bli 1 u t th1 1 uc f t1mmg. The Imp rt 11 c f the c [! ur pr idcnt; qum and (2 ), and nitz (2 0 ) b th r tou h mu t be c mt rtabl and be uitabl m rclati n t the c u11 ell r' around t uching and being t uchcd (Kcrtay c1b . ti c he u c f wn c nccrn R vi rc J 99 ). We tland (20 1 I) take thi a tep further in tating that b th th client and the c un ell r, in the moment, and with one another hould be c mt rtable with t uch . It i not enough to be c mfortablc with touch in general. ach client mu t be con idcrcd individually and each moment con idered eparately . Open communication and que tioning arc fundamental in evaluating client re pon c to touch. it origin, and there i tance lient need help to recognize the need for touch , urrounding it (Durana, 1992). However, Holub and Lee (1990) argue that in order to bring about under tanding and change, the client's need for affection and physical contact hould be a e cd in therapy and not placated by the therapi t. The deci ion mu t be mutual, at each moment and in each in tance. If a therapist ha a trong need for tandardization of hi or her treatment approach , the idea of physical contact may be inconceivable, inducing fear in the therapi t. the c fear be communicated to the patient, the collap c of treatment would follow hould 22 (Kup~ rm u nn m l in , 1 f t uch mu t b th e th crap uti r a lm that th er ). hi n 1pr r h r n cd [! r ph m[i rtabl c with th e [! r n t utili z ing t u h in ith li nt hi h th r it b p r li ent i n t ham d (H rt n t al 1 th rapi t wh arc un an r th rcti al tan i al r a urancc r u h an intimat intcra ti n ann t be inau thcnti and ultimat 1 it i th c un ell r ' h n ty ab ut h1 p t hi her tr ngth tha t h lp a eli nt in rd r m[i rting r inv luntary r her lim itati n a w 11 hi r r her wn tru th a well Ku pfcrm ann ma ldin , 19 7 . ommunicatin o bo und a rie . There i remain lear ab ut boundari e awar nc ell -defi ned rca n ing th a t th crapi t mu t hat he r he i d ing and c l ar inc mm uni ca ting lim it and urr unding th e u c f t uch in th rapy ( ci b, 199 ). ur mcrca mg of e ua l abu c in th th erapeutic cttin g cr c an incredibl y imp rtant purpo e. It heigh t n our awa rene pecifi cally a exual one, ca u f th uffe ring th at any b undary vi lati n , cli ent . It i equ ally important to be aware of any eroti c tran ference or countertran fe rence (B onitz, 200 ). Prior to th e u e of phys ical contac t w ithin th e therapeuti c etting, it i cru cia l th at th e th erapist know the cli ent we ll enough to be able to under tand hi or her readin ess fo r touch , have a clear understanding of how to touch, know w hen touch i app ropr iate, and recognize wheth er the cli ent is even ready for touch (Durana, 1998) . The th erapi t mu t also be aware of how physical contact is being interpreted by th e client. It i the responsibili ty of th e th erapi t to have a comprehcn ive under tanding of how the client i likely to respond to touch ba cd on his or her pri or experi ence, ex pec tation , and perceived intent (Durana, 1998). 23 (1 H lub and on id rati n ) al r th appr pri at n t u h. Kerta andRe icr it int nt rv t k f qual imp rtan 1 p th u a it p ) add that a king p rmi ibl lariil u h mu tin lud ub tantial nd und r tanding fth nt u t u h and plaining n c1 u lc cl in the th rap uti m mcnt. ft u h na t uc h. ntmu c th u ithin th thcrap ut1 b made mutuall (T r nt cib 1 , pllll i th d ci i n t d1 t m1inati n f an t hni qu mu tal nt u tat that th d with th e tting, the d 1 ion t end it u c 20 1 . that th ll m1t and b undaric f the t u bing p ri cncc, a we ll ual a pc t mu t b c pl red w1th the cl1 cnt in the th erapeuti c cttin g. Boundary tea bing a w 11 a an awarcnc It i imp rtant to teach eli nt f th th rap1 wn b undari c arc cru cial. I ar b undaric with regard t t uch and it i nccc ary t bon tl y educat eli nt ab ut m ti vc ~ r the u c of c un cll or t uch and or lack of touch in different ituati on . It i 1mp rtant to c tabli h th at helpin g profc ional arc acting with benefic nee rather than to fulfill their own need . Th ey arc paid profes ional and , therefore, it i improbabl e they will be a part of a client' li fe fo rever (Aquino & Lee 2000). Th rapeutic touch bring about change when u ed fo r progress and when u ed within appropriate boundaric of the th erapeuti c relati on hip th at i , ba ed on the needs of the client, congru ent with therapeutic progres , and in fittin g circumstances (Durana, 1998). Kertay and Revi ere (1 993) furth er caution that cxual arousal on the part of either the therapi tor cli ent hould be used as a boundary marker, and touch that leads to exual arou sal mu t be di continued and processed expli citly. Horton et al (1995) add that wise clinical judgment on th e part of the therapi t, vigilant monitoring and above all, genuin cne s and honesty between th erapy partner 24 mu t r main param unt. K rta and R refer ncing Mintz. d ing h uld n ma dupli at pr lU real. The c ntinu iting t u hit i b tt a 1d d ing Imp rtan th e av idan the coun ell r b ll v ) (1 thi furth r h n it 1 n t genuin u h trauma and in lidat ldcr, tatmg that when li nt un ti n fwh t i 11 r d a d1 mg nu u t u h 1 d h when th client d e n t t u h i d tnm ntaL and part1 ularl av. arc of mani ulating th hen n t malcfi ant t utilize n c. f equal ant t be t u h d, when hen the c un e ll r I hcnt. If- ware he u e f ph coun ellor' pr ~ 19R7) i a! t u h Within the th rap eutic etting i chall eng ing to any ional id nt1ty an d the rctical trammg (Kupfermann & maldino , practitioner who ngagc in th u f n n- crotic touch i ethically obligated to practice continua l clf-awa rene , payi ng clo e attention to hi or her comfort level , hi s or h r need the meaning of the touch and any a cia ted feeling the touch generate . Touch i multifaceted; elf-knowledge, clinical en iti vity, and the th crapi t's ability to navigate the e components with hi or her client are mandatory to en urc any phy ical contact is suitable and con tructive for the client (Durana, 199 ). Motivation for th e us e of non-e rotic tou ch. Gerstein (2004) a k ome important question in term of non-erotic touch. While he ask these que tion in ten11 of a hu g, these questions could be a ked about any form of physical contact. " Who initiated th e hug? W hy did you agree to hug this per on? What wa your under tanding of the hu g? What was the patient's understanding of the hug? And, la t, but not least, how did the hug further the relationship between you and thi per on" (p .365)? 25 It i fundamental [! r a li nt ' w ell b ing that c un ell r ar aware of th eir wn attitud and i u Re iere, 1 u ft u h ; K rtay . Th need[! r the th rapi t to be ar r garding the m ti ati n fl r the f t uch i al urr unding th u ital, ultimate! , it i the therapi t h i re p n ibl reacti n t t u h a well a the reac ti on f the cl ient ( urana, 199 ; Kertay 19 ). gender. un ell r mu t al m typ be a utel awa re f any diffe r n e in term f t u h arc an pening t ~ r hi rh r Rev i-re f client e ual intimacy and an indi at r to cca e th u c of tou h. Ha ing e p ri enced t u h in hi or her wn therapy, the therapi t' en iti ity to the u e f t uch i enhanced, thu buildi ng awa rene f gend er and p wer ue that rna or may n t de el p ( urana, 1 In order that one may r main auth enti c wi th eli nt and wi thin the therapeutic ctting, coru1 ell or mu t be cogni zant of hi or her com[! rt leve l regarding th e use of touch. Countertran ference regarding a cli ent ' request fo r touch such a a hand shake, hand holding, or a hug can be enli ghtening not only about th e cl ient and what i occurring within the therapeutic relationship , it can be info rmati ve about the therapis t a we ll (Fosshage, 2000). Fosshage (2000) talk of hi own experience of comfort with touch when he places a hand on a client 's shoulder at the end of a sess ion; as well , he addre se that some clients are never touched until the end of treatment and th en w ith a handshake. It is not enough to be aware that one is uncomfortable with touch within the curati ve realm, one must communicate one's comfort level regarding the use of touch with hi s or her cli ents as well to eliminate transference of negative feelings or interpretations such a shame that could lead to the collapse of treatment (Horton et al , 1995; Kupfcrrnann & Smaldino, 1987) . 26 warene of whos need i being met. aluat t u h wh n the b li wh n th lient percci c the aluat d a n utral r p iti e the u e f t u h m e t th n ed m u c f t u h a m eting hi th e re~ rea c n ith run arrant d 11 r ma11ipulati t uch (H rt 11 et al, 1 c ntact ha ing n emoti nal meaning a n d f th th ra i t, ye t r h r need the t u h i un ell r mu t be a ar that u ing t u h i but a g nuine re p n e t th li ent' need~ r auti n that a c un ell or mu t alway ). hi or h r n ed fr m th n li e11t may be mor likel ton gati vely f th eparate li nt. Wh n c ntemplati ng th u e f phy ical l1 d fin d i ciat d w ith t u h. en m re fu ndamental du e t the highl y hage (2 000) c ncur w ith thi finding on are earch and clinica l ba i th at, a wi th a n y~ rm f treatment, touch mu t be utilized ba ed on the cli ent ' need , and in ync w ith th e intim acy of th e therapeuti c relati on hip . H e furth er tate that w ithin hi own e peri ence he often sen e indi v idual diffe rence between client and can anti cipate wh en touch upport the need of th e cli ent. Ho lbrook and Duplechin (1994) cite Gazda when cauti oning therapists to be awa re of his or her motive when utilizing touch w ith cli ent and a k one elf whom i th e touch fo r? It i vital to be clear whether touch is for the benefit of th e client, th e th erapi t or whomever is observing. Durana ( 1998) is in agreement that the use of touch must b e for the b enefit of the cli ent, not the counsellor and therefore the counsellor must be very aware of hi or her needs in order to have th em m et elsewhere. Holub and Lee (1 990) reference Bacorn and Dixon who suggest it is both the counsellor 's anxiety that is reduced through th e u e of touch as w ell as the client 's anx iety over adverse emotions or experi ences wi th touch that may result in disregarding th e signifi cant of who's need is being met. When a counsellor is more acutely aware of hi s or her needs, as well a th e need of the client, in 27 r h r pr t ren additi n t hi oun elling ill b t rminat and the lient pr fer n r hindered du t p t r t u h the likelih d that r pairing of th r pi t and li nt i r du ed (H rton tal , 1 95). Mea ning oft uch. depending n uch can ha e e ane h initiate it. affect it m aning ( hag , 20 of the 1 el f ignificance dif£ r nt tage fag and the difference f g nder canal ). It i th re pon ibility f the ith a h eli nt. Ha mg awarene 19 7) . war n un ell r t be a war r each indi idual client, a the therapeuti pr the coun ell r ' und r tanding f hi maldin different m aning within the dyad e will be at ab ut the meaning f t uch expand r h r client a di tinct individual (Kupfennann & f th meaning oft u h D r each client en ure th e client doe not percei e touch a a b undary iolation mo t acutely a cxual one, causing great di tr for a eli nt ( ib, 199 ). Geib' re ear h he lped to clarify the meaning of touch for clients. Being the recipient of touch created feeling of being loveabl e and worthwhile; howev r thi awarene s al o created reluctance for client to bring up any adverse feelings or trepidation that may risk no longer experiencing the positive feeling . A client who perceived touch a being utilized for the need of the therapi st, also perceived the therapist as needy and vulnerable and therefore, in need of protection against a client's negative feelings. In tum it created feelings of anger, which then gave rise to guilt, making it challenging to express these feelings. In thi scenario, th e treatment emulated the dynamics from the family of origin rath er than help the client come to a resolution about them. For the clinician, being aware of the meaning of touch gives rise to understand that even something as innocuous a a handshake has meaning 28 [! r th li nt, and influ n e th th rap utic pr K ria R tere 199 . 2001). H lbr k and nti n of t upl chin 1 amin hi un elling 4) r mmend ea h th rapi t b c n at bing [! r rca ti n and a ciati n fr m th li ent. In rd er r her u e f t u h and t und er tand it in[! renee , utili z ing team ee, 20 0) . linical upervi i nand c n ultation i ke ( qum on a per onal le el re garding the u e f t u h . r herd here [th e th erapi t certainl a delicate balan whether hi ienti u ly aware ne mu t be ab le t criti ca lly analyze i i n b adaptable within th e limitati n f hi r her th erap eutic orientati n facilitated c n iderati n f whether t uch wa in fact beneficial [! r th e c li ent (Kupfermann maldin , 19 7). Bonitz (200 ) recomm nd there be a clear rationale for choo ing to utili ze non-erotic touch ba ed on a therapi t' awarene of hi or her need , theoretical orientation, hi or her own experience with touch in therapy, a well a training on the u e of touch with upervisor upport. The ignificance of therapi t ki 11 , congruence, und erstanding of th e client' needs, and the therapi t's motivation to u e touch areal o stre ed (Aquino & Lee, 2000; Durana , 1998 ; Holub & Lee, 1990; Horton et al, 1995). The u e of non-erotic touch within the therapeutic realm is one that needs to be addressed in training program , clinical upervision, ethics courses, continuing education program , and in-service training (Holub & Lee, 1990). Holub and Lee cite Vasquez ' recommendation regarding the con equence of sexual contact with clients within ethic training, including self-awareness and knowledge. 2 Relation hip Wh n tudying the u mmum ati n f t u h and amining th man fa li nt ben fit th e primiti e b g inning c n ider u h a b eing t in 1 ed u h a f t u h, a w 11 a thic t plicit ha ing mutu 1 agreem nt and elf awarene s, it i th e th rapeuti relati n hip that i th mm n 1 m nt am ng th em . main influenc wh en n id ring h th r t engag in ph 2011 ). Man a p ithin th e th erap euti c r lati n hip arc fund am ental and mu t be t tak n into c n id rati n ; li nt n he r lati n hip 1 the ical c ntac t r n t (W e tland, d , therap i t kn w ledge, b undari e , the p wer o f th e relation hip , fa cilitatin g the gro wth f th e re lati n hip and th e qu ali ty of th e re lati on hip will be refl t d up n. Client focu s. ccording to ib ( 199 ), eli nt wh experi en ce to uch a po iti ve and h aling believed th ey wcr in co ntro l of both th e kind and durati n of phy ical contact. C li ent who felt the tou ch was problemati c be li eved th ey had mu ch ay in terms of th e physical contact or were even con ulted about th eir feeling . Touch mu st be utili zed only based on the cli ent's agreem ent of phys ical contact in ord er to help him or her m eet his or h er needs. It hould never be obli gatory (G eib , 1998). Aquino and Lee (2000) stress that those who u e touch in th e th erap eutic realm accentuate the importance of th erapist skill, consider th e client 's needs b efore on e' own, and have an aw aren ess of one's motivations. Touch is to be utili zed after a thorough assessm ent of th e client 's n eeds and respon e to touch (Geib, 1998). En gaging in such discu ssion along with the therapi st 's carefull y con idered m ethodo logy to the use of touch provides some assurances for both th e therapi st and th e cli ent. A t the very lea t, tou ch can b e a b enefit of regular interaction within th e th erapeuti c relation hip and at 30 be t a mean f ignificant th rap eutic importance ~ r th cli ent (Kertay Rc 199 ). Durana ( 1 ) argue that it i the therapi t wh mu t be a untabl ~ r phy ica l c ~ r know ing th e eli nt well n ugh t det rmin e hi r her rea din e and maldin (1 ical t u h i an ther avenue that all w li ent t need t h rc arc 7) tate th at ph c mmunicat t thcrapi t what th cli ent for whom ph relati n hip W ~ r t btai n their therapeutic g al . ica l c nta t i a fundamental c mp n nt of the therapeutic tl and , 20 11 . T he th erapeuti c relat i n hip mu t be we ll develop ed in rd r that the coun read in ntact. Kupferm ann ll r kn w th cli ent intima tely en ugh t und er tand hi r her uch ha e an und r tanding f h w t utilize touch fo r the client s need , know when touch i uitabl e, and rec gn ize if the client would benefit from t uch . It is not uffici ent for th e th rapi t to hav intima te know ledge of hi or her client ; th e therapi t mu t al o addre thica l impli ca ti on w ithin th e contex t of the th erapeuti c relationship (Durana, 1998). Boundaries. Discus ion between th erapist and cli ent is essenti al regarding boundaries within the therap eutic relation hip . They must be made expli cit, and th e limits of the relationship must also be id entifi ed . It is al o strongly recommended th at there be an exploration of the po sible sexual feelings th at could be aroused (Geib, 1998). When boundaries are not m ade explicit with th e cli ent within the context of th e therap eutic relationship , boundaries remain blurred and ambi guou s (Aquin o & Lee, 2000) . The general agreem ent within th e literature i that touch should never be utilized within counselling unti l the therapeutic relationship is well es tablished and boundarie are unmistakably clear (Kertay & R ev iere, 1993) . A s the number of client who come to 31 r aliz th m lian h ar f e ualabu ein r a t b undari , b th h ical and em ti nal. li it and e n rmativ ph b undari r lati n hi it mand t parti ularl h n pl a that a h !ding ituati n i mad t ngibl e. i a! nta t in rd r t mu t be I ib 1 hon ur th b undari a th eir pain. tal 1 ar within th e c nt . Wh n the th rapi t i nd er thi t fa m tri t [ th li ent he wi h .G r ir urn tan e ell-de el ped therapeutic dem n trate genuine regard and f th relati n hip , th cli ent p nly arti ulate hi r her w rri e and .G ar . Th d ad f th rapi t and li ent re in rclati n htp with ne an ther and there.D re a afe en ironm nt i .D rmed (We tl and , 2 11 ). Po we r of relati on hip . It i n w nder th at t uch i a di ffi cult topi c to expl re with a client gi n the intri a ie and influence f th e th rapeuti relati n hip . Traditi nall y, touch ha been pr hibited t together eliminate n ure that boundari e remain clear. Avo iding t uch all ome of th e worry of exual abu e and b undary violati on occurrin g between client and coun ellor ( eib 199 ). The power di fferential between cli ent and coun ellor i not to be taken lightly, parti cularly when phy ical contact is u cd wi thin the therapeutic etting. It is the obli gation of th e therapi t to uph old tricte t of ethica l considerations. When a e ing power di pari ty within the relation hip, one must also be cognizant of cultural and ocialized difference between cli ent and therapi st (Holub & Lee, 1990). It is al o arguable that a trict avoidance of phys ical touch without excepti on could mimic the physical rejection of the cli ent experienced in childhood. This rejec ti on could reinforce the denial of the phys ical elem ent of being human that i parti cularly typical of the ob e ional and chi zoid per onalitie in our culture and ould increa e the likelihood that clients mi ght depersonali ze the therapeutic relati on hip to pro t ct again. t 32 p ri ncing fe ling thu n 1 nger pra ti ing with b n fi maldin 1 n (Kupfermam1 7). Quality of th e th rap utic r lati n hip. hang wh nit i u d t b n fit th gr therapi t' th r ugh a h r p uti t u h can b a ataly t t th of the client. It mu t be u ed ba ed n the m nt f the client' n i tua ti n ( urana, 1 d , at the right tim , and in the pr per d timing i fundamental. uch h uld n t be e pr ed a a need r reque t f the thcrapi t, and linician mu t be familiar with the intimacy of the r lati n hip a th client e peri en it eib 1 . Intima y within the relation hip mu t be uch that the u e f t u h become a natural ch ice to enhance client w 11 being (H lbr ok uplechin , 1994 . In rd er to facilitate growth of the therapeutic r lati n hip, touch mu t be a genuine tactic to enable client growth within the confin of th r lation hip ( eib, 199 · Kcrtay & Reviere, 1993 ). Geib (1998) argue against the deci ion to utilize touch a a theoretical tance, tating it need to come from a place of genuine regard from the therapi t. Geib ( 1998) quote Michael Balint, "In contrast to ' insight ' which i there ult of a correct interpretation, the creation of a proper relationship results in a 'feeling': while ' in ight' correlate with eeing, 'feeling' correlates with touching"(p . 113). Open communication, intimacy, and trong alliance are a few of the factor that influence the quality of the therapeutic relationship . The use of touch is fundamental within the context of relationship, and without it the relation hip i not whole (We tland , 2011 ). Touch can be con idered a powerful instrument, which emphasize a more open and intimate relationship between client and therapist by augmenting the therapeutic 33 partn r hip a it fa ilitat a de per l el f tru t, urana, 19 nne tion b tween linician and cli ent Man r hi h in tum trengthen the ). ar h r argue that t uch mu t be c ngru ent t th 1 el f intim a y w ithin the th rapeuti relati n hip ; that i the ph i al intima y between un ell r and li nt mu t match r be congru nt t th em ti nal intima ( qu in e , 2000 ; onitz, 200 · Durana, 199 ; F rt n et al, 1 5; Kertay Rev iere, 199 ). Th reD r , th hage,2 eib, 1 r mu t b ertain that the le 1 pm nt f the m ti ona! intima y Kertay tou h i m re like! t bee aluated by the cli ent a 1 f phy ical intimacy n t Rev i re, 1 fac il itative~ r ), thu the hange ( urana, 1998; Horton t al, 1995). Wh nth therapi t pro ide a etting in which the cli ent fee ls in control, therapeuti c outcome ar po iti ve ly affec ted. Of equa l importance to therapeuti c outc me i th e me age from the therapist that technique invo lving ph y ica l contac t are utili zed based olely on the client ' need ; whi ch mu t be openly di cus ed rath er than avo idin g th e topic (Geib, 1998). Holbrook and Duplechin ( 1994) agree on th e importance of positively influencing th erapeutic results by creating a level of intimacy th at i comfortabl e for the cli ent, which communi cates positive fee lings. The importance of th e quality of the therapeutic relati onship is highli ghted. The research suggests that th e use of non-erotic touch within the th erap euti c etting can significantly improve therapeutic outcom es for many cli ent . Touch has long been associated with healing in many cultures. Th e u se of touch prov id es an alternative, yet powerful form of communication between therapi st and cli ent when verba l communication is inadequate. Not only does the use of touch commun icate accep tance 34 f the client fr m the therapi t it 11 w th client t m r ef:D ti ely r 1 te with hi h r therapi t. Thr ugh the u oft uch an empathi i fa ilitat d thu all ing [! r intima y between the un ing ph m1e tion i [! rm d, und r tanding mmum ati n n a deeper le el thu al o trength ening lling dya d. i al c nta ct can be f gr at benefit t man cli ent . menti ned the u e of n n-er ti t uch can increa e p iti e therap utic utc me thr ugh a number of a enu f rea urance t ward the client, increa ing client in luding cr ating a lf-di cl r n ure and increa ing th tru t wi thin the coun elling dyad . ing touch can be reparati e [! r eli nt . Touch i a p werful technique uch a when a gentl e tou ch on the hould r r kne [! r e ample, can a i t a client e periencing great emoti onal pain. elf-acceptance i al o achie ab le through the u e of touch for many clients as it not only create tru t within th e therapeutic realm it can create a en e of tru t within ne elf, and - repairone ' en eof elfbyincrea ing elf worth andone'ssen eof power. Some re earcher go o far a to tate that not engagi ng in touch wi th clients is more damaging as it reinforce a cli ent 's en e of rejection and neglect (Aquino & Lee, 2000 ; Durana, 1998 ; McNeil-Haber, 2004; Phelan , 2009) . The lack of touch can be as communicative in negative neglectful ways as the use of touch is communicative in positive nurturing ways. There is a primitive component to touch that brings one back to the moth ering nature of touch. The use of non-erotic touch facilitates the ability to form normal, caring attachments with others, mimicking the sense of love and safety one feels from such nurturing touch . Touch is vital for normal physiological and emotional development. 35 There i an ethi al mp n nt t th u e f n n-er ti t u h that cann t be ign red . It n t n u gh to impl ch with e to u t u ch w ith a li nt. Th therapi t mu t be ry client and with e ery inciden e ft uch a t hi In o d ing, the th rapi t mu t b hyper awa r f t u h, and the client ' f h plicit r her m ti ati n D r t uch . e need ar b ing m et with th e u e mfort le el t be th e rec ipi ent f t uch . In ther w rd , there mu t b mutuall agreed up n term D r th u e f t uch . defin d D r th rap euti c dy d, de e l ped ut f awa rene b e of benefit t a cli ent, it mu t und ari e mu t be clearly and openne r the t u h to me fr m a place f genu ine care fo r on e ' client. La tly, it i th e th erapeuti c relation hip that bind a ll th e e factor t ge th er. Wh en th e re lation hip b twe n eli nt and un ll or ha b en e ta bli bed in a caring environment, w ith e pli cit, mutua lly agreed up on bound arie , and e pectation ba ed on the need of the client, care i dem on trated . pen communi cati on , intim acy w ithin th e relati onship and a trong alliance are all fac tor th at influ ence th e qu ali ty of th e th erapeutic relationship . It i a th ough all th e fac tor di cu sed regard ing th e u e of touch are th e ingredi ents to a favourite recipe, and the relati on hip is th e oven th at cooks the ingredi ents, giving you th e final product. Just like any recipe, you can adjust th e quantity of the ingredients to suit your tastes; neverth ele s, in th e end th ey are imply a bunch of ingredients mixed togeth er until they have b een in th e oven to cook. One can similarly adjust th e factors n eeded to dem onstrate care through th e use of touch, but only wi th a w ell-established relationship, can care be demonstrated and th erapeuti c outcomes achi eved. 3 hapter Thr Methodolog ualitative Introduction ualitati m th d f re ear h 1 k b y nd number and addre hen m na behind the numb r ( kn ledg than quantitati meth d c rtainl ha an 20 thu pr du ing a dif[! rent le el f m th d can pro ide ( orrow 2005). While quantitative th ir 1 c, the d n t ackn wlcdgc r e amine in detail conte tual de cription of li ed c peri nc r earch or qualitati e inqui f r carch parti cipant . ualitative i inter ted in th de cription or story of each re earch participant t greater und er tand th uniqu e li ed 2009). What the t ry r pericnce of each participant (Mayan, e k.n w a human i a direc t re ult fr m ubj ectivc encounter or situation ( aelli, Ray , & Mill 2003 , and touch i a direct enco unter; therefore, a qualitati e methodology approach t re earch on touch i neces itated. Specific Qualitative Method ology Phenomenological re earch according to van Manen (1997) is the study of phenomena. It is the study of lived human experience, also referred to as lifeworld. One's lifeworld constitutes four fundamental structure or themes : lived space, lived body, lived tim e, and lived human relation. Through the study of experiences or the existentials of one's lifeworld, interpretations are made to gain meaning about what it is to be human. This meaning is deciphered based on past-lived experiences and the meaning associated with those experiences . Thus it is how such phenomena being studied is then written to reveal it that will lead to consciousness. It is through language, the writing and re-writing that understanding is conveyed (Laverty, 2003). It is because of this consciousness or awareness of phenomena that true meaning of what the experience is like or the nature of 37 rk f h nnen uti ph en men 1 gy all w D r what r adamer a ited m a ar h r, and th h wn li ed pen n b ill read thi r ften it t int ret thr ugh th ir n ible h rizon . tud i n t D cu cd n wh ther th ph en men n f t u h i wid e pread, how cur , r it relati on t concerned with 1enc ar h, the abili th nd what i imm diately e ident and reate r make p n w und r tanding , r Thi rty, 200 ) all ha ing a h n z r whi h pr vid hat th th r behav i ur . H rmeneutic phen men 1 gy i p n n e f th ph n men n i . Ph n menology i a human tud ing ph n mcna r the meaning of the li cd human w rid (van M ancn, 1997) · theref r , an interpr tiv h rm eneuti c phenomenology framework i warranted to gain a deep r, ri her under tanding f the experi ence ft ouch to demon trate care w ith youth. My goal wa t gain in ight into the u e of non-erotic touch in practi ce and -contributing guiding fa ctor urrounding the deci ion t u e touch or not. By interpreting experience of touch and tudying what it mean to demon trate care through th e use of non-erotic touch, thee ence of these experi ences provide understanding to th eir significance. Hermeneutics i an interpreti ve proce s, (van M anen, 1997); th erefore, th e qualitative methodology for thi s re earch is also of an interpretive nature. Van Manen (1997) outlines six research activities used within th e hermeneutic phenomenology framework. While these activities are li ted, th ey are not sequenti al activities or steps to the research process. These activities may be worked on at th e arn e time or concurrently. The phenomenology re earcher examines the nature of th e lived experience, meaning that the researcher has a phenomenon in mind, and practices thoughtfulness of this phenomenon to make ense of what a pect of human experience 38 that e i t . Herm neuti ph n m n 1 gy ha th p t ntial t fa human pen ence. the am ph n men n, n ther re ar h r ma hi ch rev al p on int rpr tati n tan th r elu idati n f uld complem ent the initial interpr tati n r e en pr an ther m r in-d pth und r tanding. Thr ugh ut the tud , th re earcher in th pen en tiga te a it i li ed meaning the ri ginal e peri ence i inve ti ga ted. It i thr ugh king at thew rld with a n w awarene what the ph n m n n i lik r that the r a re-awakening that tru e under tanding of ence f th ph en men n i identified. e p ri n e i th n r fl e ted n thr ugh e entia! them e pen en ide and refl ec ti de ived y re earching the li ved 1 p ing a new h ri z n, that which wa diffi cu lt to under tand i mad cl arer. What i tantamount t the nature of li ed ex peri ence can be a ked whil e con idering tim e, pace, thing , the body and other . Thro ugh language and the writing of langua ge, the th oughtfulne of a phen menon i brought to illuminati on. It i throu gh the writing and re-writing of the shared experi ence th at give voice to th e phenomenon and allows the sharing of thi experience with other . Another activity th at keeps the re earcher focu ed on th e study is maintaining a strong and ori ented relati on with the topic or question being asked. As van M anen (1 997) de cribes, phenomenological research can be demanding of th e researcher and th erefore it is imperative not to be side tracked or tempted to veer off course with a umptions and judgments. It is vital that there be a strong commitment to the re earch questi on . Finally, there is balancing the research context by considering the part and the whole. The researcher must consider how each part contribute to the whole and th en how the part and the whole contribute to an swering the que tion. While van Manen outlines these activities they are not set out to follow without prior examination or preparation, the e 39 a ti i ti rtainl h lp to guide there ar h r thr ugh them thodol gi al maze f phen men logy . "int rpreti e an Manen (1997) ugge t that r n iti ity inventi th ughtfulne arch r qua litie uch h larly tact and writing talent" (p . 4) a! o pla a cru ial rol R e earch Procedure R ecruitment of particip ant . Parti cipant w re recruited for thi purp tud y using eful criteri n ampling t en ure that partici pant had e peri ence with the ph n mena fu ing n n- r ti c t uch to d m n trate caring with y uth . ch ol coun cllor , and community n mmunity and hild and Youth M ental Hea lth clini cian from a mall anc uv r I land in Briti h olumbi a w h were adult and who had worked with youth D rat lea t oney ar were a ked to participate in thi tudy. I recruited nine participant . Consent. Formal information letters were written to counsell ors and clini cians employed by community agenci es, the sch ool board , and Child and Youth M ental Hea lth , inviting them to participate in this tudy. These letter outlined th e natu re of th e study, and addressed confidentiality and anonymity . Benefits and ri sks of parti cip ating in thi s study were also summarized. I sent out seventeen invitations and received nin e pos itive responses to participate. I was encouraged when I received eight positive responses to participate within the first week of sending out th e invitations. One participant was unclear that the invitation I sent was to participate in my research . I clarifi ed that it wa an invitation to be a parti cipant in my thesis research and to be interv iewed by me. The ninth participant agreed to be interviewed after fu1ih er explanation . 40 Wh n I m t ( ppendi if th read th c mpl t in itati n ) and qu ri ed if th re were any que ti n . th in itati n nl per ith ach participant I nqmr 11 nine participant repli d that a r ad and the had n furth er que ti n . I reiterated that I w uld be the n li tening t th e audi otape of th e inte1 iew and addre ed an nymity and c nfid ntialit a utlined in th e in itati n ( e ppend i check d ff the appropri ate re p n e to th e qu e ti n be:D re c mm ncing th int rv i ( ee pp ndi on them that I btained fr m the Internet by g ""' ach participant read and n the c n ent :D rm and igned it ). I prepared card wi th name written gling p pular nam e of the 195 0 . participant pi cked a card fr m an n el pe to pr vide them w ith a p eud onym . participant wa pro ided with a li t f re urce ach ach hould any of th em ex p e ri e nce a ny emotional or psychological di s tress following th e inte rvi ew (see App e ndi x C) . Seven participants e ither refused th e li s t of res ourc es or look ed it ove r a nd r eturn e d it to me. Two participants kept the list to re fer to for profess ion a l r eas on s . Interv iewing. The fir t ph enomenological interv iew with each parti cipant took pl ace in a location suitable for the interview process and wa conveni ent for the interviewee . All nine participants were people with whom I have a developed relationship in whi ch there is an element of personal sharing and approachability as sugges ted by van M an en (2014) . I intervi ewed each participant rather than requ est a written acco unt of personal experi ences because writing can be a refl ective exercise, which could compromi se the sharing of lived experiences. Th e interviews were face-to-face, and open-end ed la ting approximately one hour. To keep the interview fo cused on the imm ediate lived experi ence (van Man en, 1997) each interview was guided by my primary research qu estion: what are your experiences of using non-eroti c touch to demon trate care in 41 profe i nal h lping pra ti e what fact r influen ith y uth? ndary que ti n guided the int rview : y ur deci i n to engag 1n non-er ti t u h or n t? When the con er ati n becam m reg neralized and m ou g1 em an e ampl e." ed fr m li unng ach inte ie mam r ear h qu ti n at th [! r fr nt f my mind hear each participant e pen en d perience I asked, " an it wa imp rtant [! r m t k p my that I c u ld be full y pre ent and t ry in rder t e trac t ri ch detail f every participant b a kin g p n-ended que ti n toe pli ca te parti cipant ' c pcri ence . ach intervi ew wa audio tap d and tran cribed erba tim by me. Interview ing c !l eague and peopl with wh m I ha a de l ped relati n hip wa exciting yet al o anx iety pro oking. I wa nervou about a king the ri ght que tion to ga in enough detail for my analy i y t I wa e cited to hear other pc plc' e peri ence . After the fir t couple of interview I becam more exc ited as I could already hear emerging th eme between interviews. I wa excited to complete the remainder of my interview to see if the same theme would become immediately evident while hearing sub equent experi ences. Immediately following each interview I wrote in a refl exive j ourn al to document my own opinions, beliefs, and value in reaction to my ob erv ations of each participant's interview. Ethical Concerns Confidentiali ty. Parti cipants in this research were required to ign an informed consent form outlining the risks and benefits of parti cipating in this proj ect. Because the topic is of a sensitive nature, the limits of confidentiality were outlined and empha ized. I will uphold these limits of confidentiality hould a participant ' empl oyer learn of his or her participation and request access to my data . Partic ipant had the option to remove 42 them el e at any time fr m th re ar h tud with ut e planati n and Their data ith ut p nalty. uld ha e been removed fr m the tudy. I c ndu ted in-depth face-to-fac e inte1 iew with each p Iii ipant, and a the re earch er I tran cribed a h intervi ew my elf a well a I will al a ur ndu ted th e anal i D r the int rv iew to m aintain nfid nti ali ty by k eping all in:D rm ati n for tw year after publicati n und er 1 k and key in my office. Parti c ipant m p nni nfidentiality . i n t u e the data th y are ab ut t pr igned a relea e :D rm granting ide me w ith D r any future u e uch a re earch publi ati n and pre entati n. Before th e fir t interv iew commen ed, parti cipant were bri efed about th e re earch proce , the rational e :D r th e tudy, how the interview th ey were ab ut t parti cipate in helped contribute to what I ace mpli hcd thr ugh thi re earch, and th ey were given th e opportunity to a k que ti on and have th em an wered to their ati sfacti on, a well a voice any concern regarding the research proce . To protect the anonymi ty of the parti cipant pseud onyms were u ed. Th e use of extensive direct quotes can reveal the identi ty of parti cipants, and therefore were onl y used with participant approval. Any electronic data i pa sword protected, and identifying information is stored separately from tapes, and transcripts are locked in a filing cabinet in my office. Data Analysis After the completion of each individual intervi ew, I wrote in my refl e ive journal to observe my own opinions, beli efs and valu es. I listened to the audiotape w ithin 24 hour of each interview while I was still famili ar with how the interv iew occurred. I re-read my reflexive joun1aJ and made any additi ons after I rev i ited the interv iew. I th n began 43 the pro e f tran cribing the audi tape. The fir t tim I heard ach audi tap I felt m r lik a true ob crver f th parti ipant' eliciting c p ri n e and per gam a en f fa mili ari ty it wa cl ar th at nal t ri c . peri nee rather than a partic ipant in I li ten d t the inter iew it wa ea icr to ith what wa being bared. me imilariti c ft r the fir. t two r three ere emerging, which then b came theme a the imil ariti c became c ntinu u ly m re c n i tent among t parti cipant . I began t hear an wcr t m y qu e ti n what ar th e pericn e f dem n trating care toy uth thr ugh the u of non-e roti touch . Hearing the audi otape wa the beginning of m y thematic anal i , c n idcring a h inter iew a a whole and a king my elf h w doc each int rvi ew a a w hole addre th e mai n igni ficancc f the rc earch? Th e econd time I li ten d to the audi otape wa when I began to tran cribc each intervi ew. Once the tran cription was completed, a phenomenological analy is simil ar to that as described in va n M an en ( 1997) where ignifi cant statements from th e transcript , which answered, ' What seem s particularly e cnti a l or revea ling about the ph enomenon or experience being described?" (van M anen, p . 93) were hi ghlighted. The signifi cant tatements were analyzed for emerging themes th at spoke to th e experi ences of using non-erotic touch to demonstrate caring w ith youth . Wh en themes emerged, they were checked for accuracy by questioning if th e experi ence or the phenomenon would lose it' s meaning or remain th e same should a theme be removed. These them es then were written into thematic statem ents and eventuall y into paragraphs describing th e experience of each participant. orne quotes were used as a means of borrowing pmiicipants' exp eri ences and their refl ecti ons of the e experiences . 44 a tl I anal zed a h parti ip nt p n n d m n trat ar . nt n indi iduall t al kif and h wit r veal in r lati n t th e ph en m n n f u ing n n - r tic t uch t m r d tail d appr all w [! r clu id ti n f a m r ht in-d pth m amng f th e ph en men n t emerge an M an en 201 particular! rc ea ling qu pa l a c unt p n n p rti ipant of th 1r rc u d a ar h d it. Through th e pr c ga m, any f the ph n m en n a th e f wri ting and rc-wnting, the tru e c en c p n n amc t light, pr iding a ri h de cripti n a ll wi ng th e rea der t trul und r tand ha t it i t c p n n u mg n n- ro ti c t uch t dcm n tratc care ( re well 200 7). Th li d p n nee lifcw rld e th f th nin e parti ipant w re refl ec ted up on u ing va n M ancn ' f li cd pac , li ed body li cd tim and lived th er. It i through e e i tcntial that th e reader di over what mak th e ph enom enon w hat it i and th e true experi ence i rc ca led (va n M an en 1997, 20 14 ). Each c i tcnti a l wa tud icd and explored through th len of th e partic ipant ' experi ence . The c ex i tenti al were guide for con ideration through th e herm eneuti c analy i of each tran crip ti on. For each existenti al I qu eri ed how doe lived pace, li ved body, li ved tim e and li ved oth er re late to the true exp eri ence of the phenomenon of u ing non-eroti c touch? Van M ancn (20 14) describe each existential and provides question I u ed to help guid e thi refl ecti on . Evaluative Criteria According to Yard ley (2000) , quali tati ve m ethodolog ies arc uniqu e in detenn ining evaluative criteri a, a qu alitati ve research mu st b e open to a w id e vari ety of approachc to fu lfi ll criteri a requirement fo r va lidity. For thi s study, van Manen' (1997) 45 m thod 1 gi al c nditi n were u ed t t tural n ur m re earch findin g were valid. Th ndition n eded t be ri ent d tr ng ri h nd de p. Orient d. an Manen ( 1 parating th ry fr m li fe and being ri nted t th w rld in an inD rm tive manner. When a r arch r i 7) tat dynamic t th re arch r mean n t ri ent d to a phen m en n there i an int re t in the li ed e pen enc a well a a c mmitment t th r ear h r I al that t be ri ent d a ta uthentic t the nature f the e pen ence. ori nt my elf t th li few rld a that of th e un ell r. eing full y p ri ence f t u h a it i li ved i pr [! undly intere ting for me a the re arch rand I id enti fy th e u of t uch a a true phen men n, ne th at hum an live through . Hermeneuti c ph en meno logy i the tudy f human ph enomenon utili zing both de cripti ve and interpreti ve method . The analy i of th e re earch in clude a depi cti n of the participant experi ence through thematic analy i . Interpretati on of th e meaning of the phenomenon throu gh xamination of th e exi tenti al th emes is used a a guide for refl ection revealing th e true li fewo rld of the experi ence of th e phenomenon. Through the proce s of analysis and continually askin g my elf while reading and re-reading transcript , what i essential to th e experi ence of utilizing touch to demonstrate care, I rem ained ori ented to the phenomenon, which in turn allowed me put into wo rds w hat the experience is like. It is the act of touch and the intention of the touch that makes thi phenomenon a human experience. Strong. To gain clarity in know ing the experi ence of using non-erotic touch to demonstrate care, the use of emphas is on producing informative under tand in gs, elucidations, and interpretations, strengthens thi s resource in the very practice of thi research. Through the use of isolating themati c statements, clari ty i achieved thus 46 pr ducing tr ng ri entati n t th li£ w rld f th parti ipant ( an Manen 1 97). The u f parti ipant dire t quot pr ide th read r with tr ng and£ nnidablc und r tanding f pa1ii ipant e p n nee capturing th phenomenal g i al m eaning of u mg n n- rotic t uch to dem n trate care. th mati analy i a well a irect qu t ar utili zed thr ugh th h n r fl eeting n the c i tenti al theme , giv ing clear and powerful m ea ning of the true lifcw rld f the p articip ant . M aintaining a rcfl c ive journal thr ugh ut th re ear h pr cc phenom n n b all kept me tr ng in my ori enta tion to the ing me t r fl ee t n which part f th e interview I wa analyzing were an w cring th e re earch qu e ti n whi le at the a rn e time re fl ecting on any per onal bia e or prejudice . M y j oum al wa al o in trumental in keepin g me D cu ed by providing m e an avenue to track my mu ing that kept me fro m becoming id etrackcd in my writing. tay ing tru e to th e e perience of u ing touch to demonstrate care al o allowed m e to tay strong in my ori entati on to th e re earch qu esti on. Rich. A rich and thi ck narrati ve is olid when re earching a ph enom enon throu gh th e interpretation of lived exp eri ence. The truth of one's tory retrieves what is uni que, precise and distinctive in a way th at only a participant's story can be (van M anen, 1997) . It is through th e gathering of participants' tori es and experi ences that the data retri eved is rich. The u se of parti cipant direct quotes furth er supports the ri chness of individual expen ences. Deep. Depth is what gives m eaning to th e phenom enon being studied . Van Mancn (1997) quotes M erl eau-Ponty , "D epth is the m ean s th e things have to rema in distinct, to remain things, while not being what I look at at present" (p . 152) . W hen description arc ri ch, and explore th e m eaning beyond what i imm edi ately ev ident, then a dimen ion of 47 d pth i gained ( an Man n 1 int r 1ew t hu thr ugh th u e f int w an ndary larify m eaning d pth i attained and a rich r e peri en e i reveal ed. Evaluation of th T 7). tud n ur th th m and de cripti n f li ed e pen en were refl ecti ve and accurat -[! r each parti ipant' e pcrien e, I mailed a h pa1iicipant an indi vidual ummary and th final to fac t di cu mp ite igure 1). I mm unica ted with fi ve participant fa ce their th ught an agreement with my analy i . parti ipant wa an pp rtuni ty-[! r met al o clari fy rich r detail in m y analy i . I al a ked fo r permi mmuni cating with me que ti n I had and pr vide i n to u e dir ct quote . Of the fi ve participant I met face t fa e two reque ted ome edit to their quote where repeated word w re remo ed. Thre parti cipant confinn ed via email th at th ey were in agreement with my analy i , two however were unhappy w ith how th eir qu ote read. f these two participants, one participant asked me to change som e wordin g to provid e a better flow to her word and another participant rewrote her qu ote to better refl ect her true experi ences. One participant wa unabl e to meet face to face owe reviewed my analysis and her quotes toge th er via Skype. Thi s parti cipant wa in agreement with my analysis and asked for some quotes to be edited to read more smoothly. None of th e participants requested a copy of their transcript. Overall the feedb ack I received was that my analysis was a good refl ection of the participants' experience . I maintained a refl exive journal throughout the research process to monitor my own assumptions, frustrations, challenges, and thoughts and feelings about how th e research was unfo lding. I also tracked my bi ases about any of the participants or interviews . Whi le ana lyzing the tran cripts I u ed my journal to document per onal thought about 48 what I a r ading, to manage my wn p r nal bia d cument my wn mu ing true to th e penence n th emerging theme in order that my analy i would stay f th parti ipant . My j urnal wa e trcmely valuab le wh n recalling m th ught pr ce the writ up f my anal and preju i e a well a to after li tening to audi tape and after tran cribing. unng i I r ferrcd t my journal a a d cument f my e periencc of clearly determining th th me and the o crall e ence f the parti ipant ' e periences . Thr ugh ut the inte iew pr ce of factor I maintained my elf-awarenc and wa cognizant u h a influencing participant de cripti n , accurate tran cribing of interview , drawmg my own c nclu i n rather than tho e of omeone el e, and maintaining tran parency throughout the analy i pha e ( re well, 2007). urn mary An interpreti e hermeneutic phenom nological approach has been outlined as it was used to pre ent the lived experience of those in the helping professions in order to understand the true e ence of using non-erotic touch to demonstrate care with youth. The details of how this research has been conducted have been outlined. Ethical concerns have been identified including confidentiality of participants ' information and vulnerable populations. Through analysis of verbatim transcripts, a composite description detailing how the essence of research participants ' experiences has been revealed. The following chapter outlines the research findings revealing the themes of communication, relationship and decision-making factors and overall essence of the participants ' experiences as awareness while using touch to demonstrate care. 4 Chapter Four: Res earch Findings a d nth int rvi w with th nin participant p nen f c mmunicati n , relati n hip and fa ct r influencing i i n making and con equ entl awar n tud , a 1 ar under tanding fu ing n n- r ti t uch t dem n trate care with y uth b came ob wu thr ugh th e at g n e d f thi . Thi chapt r nli ght ning the e ill addrc n e f th i e p eri ence a e lf-awarcnc . T o eluc idate the c pcri cnce [ u mg n n- r ti c t u h t d m n trate care tc tural and tru ctura l narra ti ve , an ecdote or p rti n f c n cr ati n arc u indicat th e li ed c pcn en were gi en p ud n m : d . Th e qu ote fr m interv iew arc italic ized to clearly f parti cipant a oppo cd t my wn. The parti c ipant nne, ynth ia, Pam ela, u an , D eborah , M ary, and Betty to protect the ir identiti c . any identifying qu tc aro l, Mi chae l 11 n ine parti c ipant live in mall communiti es thus r info rm ati on ha n t be n provid ed. o, du e to th e sen iti vc topic of thi th e i , it i important to protect th e identi ty of th e counse llor , whi ch in turn al o protect th e identity of their cli ent . Through the proce of writing and rewriting m y findin gs , it becam e increasing ly clear the theme of communication, relationship and decision-making fac tor were shared among the nine participants. However, awareness was revealed to be th e overarching essence of the experi ence, and also the mo t difficult to arti cul ate. It supports all the themes and categories, y et cam1ot stand in iso lati on . Not one category exists in isolation without addressing the importance of awarene s and its influ ence when using non-erotic touch with youth . When I first started analyzing my findin g , I kept thinking about awarenes s as the top part of an umbrella or th e canopy overarching th e other themes, as though it encompassed them. Upon fmih er eva luati on of th e th eme , I so came t r alize that I had my umbr lla lab 1 d up id d wn. th umbr lla, upp rting the an p f maintaining it meaningful ay. haft of f t uch i in the handl e, quite literally haft f th umbrella, waren hape effl cti en i th mmunicati n, relati n hip and deci i n making fact r . The care demon trated thr ugh th u wh re it i in our hand . Th warene , and all , i vital t th e umbrell a cr a ili ty t fun ti n r perate in any 51 cci i n Making Fact r R lati n. hip , warcnc Figure 1. The Umbrella. Much like an umbrella, the es ence of awareness support the over arching themes of communication, relation hip and decision making factors. The handle, care, is in th e hands of the one utilizing non-erotic touch to demon trate care . 52 With uta ar n thcra n uti rclati n hip ann t effi ti cl c mmuni at , de r r fl ct n th n t. In t rm tim , th e an p keep th e umbr lla t ad . t ill n t b f~ ti 1 p meaningful t r influ n ing th dcc i i n t u c t u h r ann t be upp rt d with ut the haft and handl e t qu 11 tmp rta nt, a haft during a rain t rm . It i ith ut the can py i ju t a haft . It lear th mp ncnt f th an py: c mmunt ati n, thcrap uti r latt n h1p and fac t r mflu n ing the u c of t uch cannot c i t r p rat f~ ti cl up n in all nin inter tew ; h w parti ipant in term nl y n mp a haft, awarene warcnc wa t u hcd r, wha t ne need t be aware of diffe red among t f \Vha t n n ed t be aware f and t what e tent. warcnc not r infl u nee th othe r ca tcg ri , it ha many intcrc nncctcd face t that mu t b c n idcr d or that become apparent throughout the interv iew . nc cann ot con ider an of th e th cr ca tegori c without addrc ing the importance of awarcnc . There i ome overl ap a many categori c have overl apping th emes. It i impos iblc to write about th em a di ti nct cntitic unto th eir own, a the e theme arc intimately intertwined. Self-Awa reness Wh en choosing to utilize non-eroti c touch whil e counselling, all partic ipant deemed awareness important, if not vital. Betty identified, "se(f-awareness is really important . .. very important ". The level of sclf-awarencs di ffered however as many had not overtly thought about their u e of touch until I asked th em to describe their experience . "I ·,,e never really th ought about that " (Pamela) ; whil e Betty ad mitted during the in terview "It did get my th oughts provoked on what I do and don 't do ", and both Anne and Cynthia spoke of it a more of an intu iti on or a natural ge turc than awarcnc . clf-awarcnc 53 1 arl n mpa d n 11 a th 1b d a ph ar 1 n ati n f fee ling. plain d " You hav to on id r your motivation . .. hoH' it j( Is .for yo urs (f so it do d ifinif I .f£ I okay, /( I appropriate". f \ hat ith li nt and a har d kn fa mil h m th ith ry and w r w rking. tt ctt p k t th ir feeling a imp rtant t th indi idual r th e addrc cd the imp rt n c f being in t u h with h r n [! lin g t ga uge th m in rd cr t rcmam . ubj upporti e a t h trai ght r cring h r h uld r which he a int n a th ugh he i di cu ing r ipr I[! und it int r ma t r' dcgr awarcne li nt . Mary al nne ted p k h r ph t1 c in a arin g and ica l dy rca ti n f 1tting up iatc w1th [! cling m rc rc la cd and p nmg up . M1 hac ! bared thi b dy awa rcnc when ating li nt t u h, "I 'd be really car (ul of that, how I respond". ting th at tw f th e nin e parti cipant had rece ntl y c mpl ctcd th eir within th Ia t c upl c fyca r . Th ey both made menti on th at th eir regarding t uch hang d within th time it to k th em to c mpl ctc th eir degree . Th y c mm cnted that they are more refl ecti ve in their own practi ce, more aware of boundari e and aware of acceptabl e prac ti ce. b crva ti on f elf pen up que ti on for furth er inve ti gati on regarding po ibl e relati on hip between clf-awa rcne and level of education. One could query wheth er education in rn a tcr's leve l coun cll ing program involving numerou refl ection cxerci es prompt one to be more elf-awa re or just to speak to it. Are those participant without rna tcr ' degree any le perhap less likely to addrc el f-awa re, or it overtly? Client Focused Awa rene More prominent than elf-awarcnc s wa the ignifi ancc of being aware of the client and di tingui hing between th e need of th e cli ent ver u th e need of the part icipant. It 54 wa lear awar ne feel when pr i an area that ne mu t be mindful of. When di u ing how one iding a caring t uch, ynthia wa lear in di tingui bing b tween her own fe ling of ati facti n with her work and me ting h r need , "I obviou I get ati ifa lion in th e jo b I [. ic} do. That i very differ nt than gettin a ne d m t ". b ing a war f meeting client wh r the are in tem1 f their c mD rt level, and being awar when t u e t u h are imp rtant fac t r D r awarene importan e f awarene u e of tou h wh n h to touch b cau !early a well. wh n talking ab ut mee ting the need nne echoed th e f her c li ent thr ugh the aid, "th ir need more than my n ed be au e I don 't have a ne d I can do it in oth r ways"; he can meet her need for human connec tion through th er m an . Pamela reiterated the importance of being aware o f cli ent need when h aid h would n t a k a client if th ey need a hug a that i omething she would not do , "that wo uld be abo ut me wanting to do someth ing, it 's about what th ey need so I am really aware of 'vvhat it is that i go ing on fo r them ", commenting on the importance of being pre ent and in tune with what a client need . Betty reinforces th e importance of being clear about whose need is being met, "I work hard at doing that because I think to me that 's what makes a good co unsellor is really being in tun e with what 's going on for yo ur client and what they need ". Communication Mehrabian and Ferri s (as cited in Lapakko , 1997) came up with the oft recited communication formula: seven percent of what we communication is done verbally, 38% is vocal and 55 % is facial , implying that 93 % of communi cation is non-verbal. Analysis of data reveals many parti cipants rely heavi ly on non-verbal communi cation when working with clients far more than verbal communication when it come to the 55 t pic oft uch. H w ver there are two di tinct c mponent t c mmuni ating, what i b mg mmunicated about t uch, and what i being ommunicated through touch. fter mu h d liber ti n a qu ted fr m my reflc ive j urna l lou h i am an of communicating that i non-verbal. ~ t, I cannot ignore that th ere i an important compon nt about communicating r garding tou ch that involve what is communi ated about the touch. It is not enough to lab 1 the actual action of touch as communicating or th e discus ion about touch a lou h a imply comnnmicatin . There i communication through imply communicating. Th re is communication through touch and in th e moment what does that touch mean? Thi is where communicating about th e touch i important to explore th e message touch conveys to en ure intent is not mi con trued and to avoid miscommunication. It became clearer to me that there was more than separations of verbal and non-verbal communicating as some participants were relying on non-verbal cue when clients communicated about touch. However, communication about touch wa more preval ently a verbal message and communication through touch was more typically a non-verbal means of interacting. Communication about tou ch. Communication about touch can be separated into two discriminately unique categories : communicating to others about touch as well a connecting with clients through the use of touch. Categorizing communication about touch as being verbal and categorizing interacting with touch as being non-verbal, the 56 re ear h c nfin11 that n n- erbal mmum ati n 1 m re fr quent than v rba l ommum ati n . e parti ipant p k ab ut talking t eli nt ab ut th e u e f t uch inc un !lin g and link d talking ab ut t u h a an imp rtant fa ct r when deciding to u e touch, which ill b further addr fa ct r parti ipant ed lat r in thi n ider hapter h n addre ing the deci i n making hen u ing t uch. cc rding to Pamela , ynthia, eborah, ar 1and Mi hael, talking ab ut t uch w ith cl ient c ntribute to the tran parency f the therap uti pr ce and an be argued a a ign of re pect t one' cli ent . lt also take th gue ing ut f w h th er th e u e f touch w ill be rece ived a it i intend ed . Participant poke to the imp rtance f being mindful fa cli ent' pa t hi t ry and being aware that t uch c uld be a trigg r fo r orn e. eeking permi ion or addressin g th e u e of touch keep it e pli cit and remove the tab o of it u e when clearly speaking about its - u e and the purpo e of th e touch . It eliminate the need to back track and apologize when touch i received in a manner that wa not intend ed. Participant relayed far more information about the intention of th eir use of touch . The intention being to enforce what has been verb ally communicated to furth er elucidate one's caring or to make the message more believable. "I've ]earned that people will forget wha t you sa id, peop le will forget what you did, but people will never forget how you made them fee l'' (Ange lou, 2014, p. l ), and this quote rings true for participants as well who use touch to augm ent their message of care for a client. Cynthia calls it, "A gesture of caring" wh en words alone arc not enough to assure a youth he or she is cared about, or when the message being relayed verball y i not being received as intended or beli eved. Touch is u cd to furth er intensify the mcs age of 57 "I'm h r . I hear) ou. I'm with you, " thu r in~ r ing a c un ell r pre ence with a lient. The in ten ity f thi me age 1 magnified when ace mpanied by a gentle tou h u h a on the kn r h uld r "I '/1, 'OU know, re t my hand on th 1r hou/d r or om thingju t to onve I'm here and how are ou ( u an)"? Th imple ge tur ( arol & client t m f t u h can trigger a client t m ve ut fa highly em tive tate ett ). In b th ar 1 nd Betty' e p rien th e u e f touch can cause the e fr m thi highly emoti e tate of crying t one f being m re calm, and not crying. The u e f non- erb al communicati n lead the c un ellor to form their own int rpretation f th eli nt b ha i ur of t pping th ir crying. arol interpret thi behavi ur a the client feeling b tter becau c he or he i no lon ger crying r as vi ibly up et; wherea Betty interpret thi touch a cau ing the client to move out that emotion or hutting him or her down when perhap it i better for him or her to stay wi th the emotion and work through it. Betty will utili ze non-erotic touch with an emotive client when he or he move beyond hi or her trong emotion on hi or her own as a gesture of under tanding how difficult it may have been for th e client to be vulnerable. I was leaning forward and she had been crying, but she had stopped so that 's when I felt I co uld touch her, that connection and understanding, I wou/dn 't have don e it while she was crying because experience has taught me that when you do that they quit crying right away and move out of their emotion (Betty) . The use of different types of touch communicates different me ages. Being aware of what one intends to communicate to another is imperative. For example, in one role of 58 h r j b Mary u e a high fi e to olidify a cri i interventi n plan with a li nt; wherea with a long t m1 li nt, I 've thought about it more, special! given th high jive . I do that in differ nt ituation a far a th e celebration part of it. I thou ht about it more on my nd with lient and u e it I ju t b au e I 'm thinking that th p r on might interpret it a I'm makin her happ_v. MaJ be th ey're plea ing me om ho-...,v when th ey do omething like the 've don e th eir hom ework a) or th e) 've done om thing and I'm like hey, great work, high five, th y might think that ' a . .. yah, that th ey're interpreting it a or th ey might only think that I'm okay with it when I do th e high .five, so th eir expectation around th ose high five might be a little bit or their interpretations of those high five and I'll like, if it was my client or a longer term relationship might be based on well, she didn 't give me a high .five today, I didn 't do as good today a last time. I don 't use it in a long based relationship (Mary) . Many participants addressed the meaning behind different types of touch. Something as a high five or fist pound can signal celebration, belonging, acceptance, acla1owledgement, or recognizing an accomplishment. For example a high five can signify a celebration whereas a fist pound can imply acceptance, belonging, "I've had kids show me different hand shakes and when you 're able to replicate and do that, it 's a form of understanding . .. to me that's still rapport building (Michael)" . A hug too can have a different meaning, depending on the situation. At the end of treatment it can signal 59 gratitud pro ide a me age that therapy wa u eful ( nne) r it can bea g a kn wl dging at ugh ion ( tur of tty) . n- r ti t u h an be implem ented in a multitude f way . With ach [! rm f t u h ne mu t be car ful t en ure that th intenti n f each t u ch i under tood . or e ample a t u h n the h ulder in th cia room can g1 e a tudent the m e age that the participant ee the tud ent tru ggling, r an imply th e parii ipant i there t help , a u an p int ut, with yo ung kid you would kne I down be id th m, p utting your hand on th ir back to con?fort th em , yo u know, to upport th em to j u t tell th em that you 're th ere ({ th ey're having d?f{tcultie . Maryu a foot tap durin g c ion with youth and their parent to acknow ledge he ee th m having a tou gh tim e a a way t acknowledge th eir truggle. Accordin g to Pamela the u e of touch is anoth er medium throu gh which he expresses empathy to client , while D eborah uses touch with youth to encompass a cultural valu e and meaning while providing a way of settling for th e youth sh e works with . Su an ' u e of touch is a way for her to check in with her clients, as way to assure they are in a stabl e fram e of mind to leave her office. It is al o a technique she uses to bring cli ents back to the present after an emotional session, providing a settling or grounding, not leaving her clients open and vulnerable. She u ses this touch as a way to communicate w ith her clients confirming they will be safe. Michael is aware of how cli ent re pond to a m ale counsellor in tern1s of touch where touch is more like a fi st pump initiated by cli ents a a sign of communicating clients' acceptance of him as well as th eir tru st in him . Anne spoke about the use of touch for safety purposes parti cularly for th e very yo ung. While 0 thi tud u mg n [! apa ity. th u uth it i rth m nti ning that t u h an b u d in thi h n w rking ith ung childr nand th f t u h thr ugh hand h lding an b [[! ti [! r k run int a parking 1 t, ping th m a[i . R lation hip ll nin p rtici ant p k ab ut th imp rtanc f the th rapcutic rclati n hip . rding t parti ipant th u c f t u h an pia the rap n I ti n hip . F r m ha in g an ary b [! re u ing t u h, hil [! r relati n hip . Parti ipant client hil al a p kc b ut h hi I for fr 1 in term fthc tabli h d r lati n hip with a client i th r t uch ntnbut t c tabli hm g thi t uch can [! ter tru t and c nn cc ti n with tting b undari ithin rclati n hip . th cr poke directly to h w t u h within rclati n hip diu tratc th e humanity of c un ellin g and i a direct di play f car . Contributin g to r lation hip buildin g. The majority of participant how the u e of touch help poke about olidify or enhance the th erapeutic relation hip, "!think at time it po sible enhances it. It help build the relationship" (Be tty). Mi chael agree that ome fonn of touch uch a hand hake contnbutc to the c tabli hm ent of the therapeutic relation hip , "!think rapport building again, urn connection . ... I 've had kids show me different hand hakes and when yo u 're able to replicate, and that um, J didn't mention that earlier for sure, can urn, it 's a form of under tanding." For Pamela it' about building and trengthening th e relation hip, " It do e help solid(!)· the th erapeutic relationship. f(th eyfeel co n~fortable eno ugh that they trust me. it willjust be an honest hug without any strings attached. " When que tioncd about her c pcricn c and what it's like for her, Anne shared her e pcricncc, 61 it' r at, ·ou know o um, I'm orr of p ri n ing th ir it m nt too o we're both 'OU kno'vl', like r cognizin um, I think it fi I goodfor th m, it ood to m that w 're r co nizing an ac ompli hm nt or som thing th 'v don w II. It contrihut to that relation hip. Deb rah' appr ach i "to tart gen tly and build that r lotion htp . .. build that trus t . ... when th J ar , ilent you know. just be in able to connect that way and again it started with lou h of th e hand on th shoulder, th hand on th e arm . " ab ut one ' e p n nc r Pamela it ' talkin g with t uch , wh n you , tart tog t to knowp ople, in a th erapeutic relationshtp, you can begin to a k que lion uch a. 'wh n you were growing up in your.family, did p eople hug or touch much ?' and \t·hat was that like for yo u ?' Pamela admit to not initiating t uch for mo t of her client ; however, he i cognizant of the importance of touch in her client's live and addre e th eir need for thi human contact and appropriate venue where touch i part of the erv 1ce uch a rna age and other e thetic erv1ce Mary ' u e of touch to co ntribute to relation hip building is omewhat different. When working with uicidal yo uth in particular, he reca lled , we 'II go through all th e safety plan, so the next tim e, so can I, can I how do I put thi now, cau e I notice I kind of use th e same wording eve!)' time, and may be it 's ju t kind of th e, in this situation, but it 's something like o urn, '! won 't be talking to yo u until Tuesday' say, I don 't know, um, 'can I be sure that yo u 're going to be safe, that you can keep yourse(f afe th en ?' and this is after all we've gone through, all the afety plan. ffthey say, ~ve. 'and 62 I'm ur I can nga in th irface th e [( th willing! cooperated and were din that proce , I'll g iv them a high jiv at that point. Mary ntinued t a kn wl dge thi intera ction i th e " tart of that relation hip and that onn tion .. . go ingfo n vard. " nn ection . on ider t u h t b a mean [ c nnecting with f c mmuni a ting th e import n e of r lati n hip and what it mean t be client in term in relati n hip , a poke f thi parti ipant ell a an indica ti on fa alli ance w ith client . o1m cti n w ith li nt in term me participant f them el e and th eir per onal m e tment in th e r la ti n hip . I'm u ed to g iving and som times they g ive it back you know, th eir energy too of um, e,pecially vvhen it ' be n a hard top ic an th ey've really, ometim e apprecwte th at touch because a lot o.fp eople are af raid to touch kids today and v. ·hen we have th at connection it 's j ust being able to say th eir touch is like thanks fo r being here or whatever it is. I get that energy back so it doesn 't j ust go one way. And yah, and sometim e I fin d that using words is not enough (Deborah). Deborah commented on the reciprocity of touch with youth in terms of her connectin g with youth . For her it communicates, I think that the biggest thing is that I'm here. I 'm with you. I'm not j udg ing y ou. I understand what you 're go ing through or you know, I j ust wanted to connect with y ou. I think each situation is d~fferent, um cause I knowfor a p erson that 's y ou know, really go ing through some hard stuff sometimes that touch is that little bit o.f reality that I'm here and I'm okay andfor 63 oth r p ople I found that ometim wh n I u it, it ' ju t harin that n rg; of uh, I ttin th em know that you know, rh tr may b d pier d by what th y 'r om through but h re I am and I'll hare om of min with you a we 'r h r workin tog ther. onnectin in a non-verbal kind of Wa)'. b rah ntinucd t plain , " 1! 's just a teaching that I grel-t' up with. It ' foreign to me not to tau h to ha1 ·e that onn cflon. " Mar al plaining it mcnti ned a p er nal invc tmcnt " h ·ing a little btl more of my p 7 r. anal self in th e hug." u an ex pre cd her own ~ cling a w 11, "I ju. r feel connected and th en Ifeelltke I 'm at least, on that level, we 'r conn cling and th n the dialogue can flow fro m there. " u an continu ed to talk ab ut c nne ting in rclati n hip , "you made one connection at one level with, with whoever it i that you're, you know, dealing with. " Betty interpret thi co nnection imilarly to what Deborah articulated regardin g cffcctivcnc in building a partn er hip with her client when he u c touch in c ion, I think th ey get a tronger connection they um, th ey feel/ike you're really invested in th em a a p erson and what th ey're saying. I think that can increase um, I think it 's mainly about th e connection and that um, maybe a sense that I appreciate what th ey're go ing through and we're working togeth er. The majority of participants mentioned timing within the relation hip . Carol talked about the appropriateness of touch during the fir t e ion when em otion arc trong and raw for the client and th e u sc of tou ch to initiate th e coun ell or c lient bond . 64 It ' probably not huge when ou have a per on coming in the fir t tim and ma b th ey 'r d a ling with orne evere prob/ m at that time and may be th 'r dealing with ome evere problem at that mom nt. R gardless of not having an; r lotion hip with them in that moment, if th 're needing ju t, it e m lik th ey 'r needing a quick touch or a quick rea uran e at that mom nt H'h n they're crying e_ sh el_v or anything like that I con id r it appropriate. Betty e pcrience with u ing tou h t e ta li h c nnection is somewhat different. ha di co er d fr m her year of practice waiting until trong em ti n he ubside before offering a touch i more effective. What I've learn d i if om one is express ing a lot of emotion and th ey're cry ing, in touching it di tract th em omehow and maybe it do es make them feel better and th ey feel connected but th ey disconnect to th eir strong emotion. Despite not u ing touch when a client is showing strong emotion, Betty ha u ed touch after a first session to establish that connection in being able to acknowledge relation hip happens all the time, right from the first session. She recapitulates , Especially early on in th e relationship, um, I mean cause the rapport hasn 't been built the same and th e connection isn 't th e same th ere, but you know I also have at the end of a session and it might be my veryfirst session with someone who has laid out a lot of information and it 's been a difficult session, even though they don 't really know me overly well, or me them, alth ough I 've just heard th eir whole story, um, I would probably ay to 65 th mum, 'I like to gil e hug ' and ifth y would like on I'd be mor than happy to. If th don 't I 'd be ju t a happy about that as w ll, and om of th m who it ' b nth ir.fir t e ion go, 'o h, thank you ' and th en we give a brief hug. It' lik validating that you 're, it ' oka } ou did all that talking and harin . I 'm conn cting with you. D borah al addre ed t uch being a way t D rm thi connection through relation hip in an n- erbal manner, "th J 're notre ponding to your words and om tim es you just, you need to have that touch on th ir, on th ir body, th eir shoulder, or th eir arm, or yo u know, th eir back, j u t to have that connection. '' who are di tr eborah peaks pecifically about youth ed due to a di cord with their culture, " o many of our yo uth feel di conne ted to th eir culture and to theirfamilies and 1 think 1 try to help them develop orne connection to one part of it at least so that th ey can feel connected somewhere. " While the u e of touch facilitate connection within relation hip for most participant , for Su an it is important to have connection prior to utilizing touch, he/she is with me, okay, we're there, we're on this level and then if that wasn't achieved during a session, if I sort offelt like we haven 't connected I would say probably I would not engage in any kind ofphysical touch with that person. Boundaries. Throughout the interviews the topic of boundaries surfaced for over half of those interviewed. When the topic of boundaries was clearly a theme while analyzing significant statements, I was conflicted how to categorize it as noted in my reflexive journal, 66 I'm wand rin wh I' it' om thin cat gorized boundari und r r lotion hip when a h pro titioner mu t b ve1y aware of Howev r, one must b awar of boundari within th e cant t of th e th rapeutic relationship. With out r lotion hip I que. lion t( a boundal}' exist or n eds to ist. oes one think of boundari . outside of relation hip ? In this conte t I qu . tion ho1-1' to d fin boundary. I b It eve boundari s an be defined as th limits w t 111 relations/ups. I am reminded of the H'ords of Robert Frost, ' ood fin e mak good neighbor. '. Thi. reinforce my I elief that boundaries xi t H'ithin th limit. of relatiOn htp and th erefore, m.v decision to cat gori::.e boundaries with the th me of relationsh ip is supported. How participant addre ed boundaric i aricd ye t th ey t o decla red th eir importan ce in reference to relation hip with client . For nne and Mary boundarie al o meant touch wa not mi interpreted . Anne aid, Just boundarie um, ju t you know being aware profe sionally, um and um would it be as accepted as much? I don't know o again reading th ose cues and relation hip, th e male and also my bound01y as well, probably my bound01y quite a bit in profe sionalism and also not wanting um anything to be misinterpreted. Mary spoke about how her u se of touch maintained a boundary resultin g in beneficence for her client, "I f elt comfortable in knowing I wasn 't eros ing any kind of boundary or um, or that the touch that they received couldn 't be interpreted in any kind of way that um, impaired th e relationship. " Pamela spoke to boundarie in term of transference, 67 wh re h i ou a hi p er anal partn r 111 rath r than a th raJ uric partn r in a th rap uti r lations hip ... . 10u hav to put up I ar boundari . F r Pam Ia, b undari h I d fin th r lati n hip ith her li ent . etty a! mm nt d hen he p k ab ut r pe ting b undari e with li ent in r lati n hi , "all th qualiti yo u H'ant to hal' all yo ur eli nts com to knOH' or com to think ab out when th ) think abo ut th relationship H'lth yo u . .. mm hmm and so in som ways 1 'm modeling that. " T ru t. Thr ugh talk ab ut tru t the tru d pth rev al it If, n tju tint rm participant oiced th imp rtan relati n hip . For f th e imp rtance f relati n hip fu ing touch but al o in th e c un elling fi eld . Mo t f e tabli bing and having tru t in th e th erapeuti c me, t uch [! ter thi en e of tru t and trength en the relati on hip , I think it i p art of the proce s. In th e therap eutic process your relationship is every thing and if a hug is going to treng th en it then it will help build that trus t. I 've never had som eone a k ..for a hug and then ne1 •er come back (Pamela) . Cynthia i in agreement that touch and relation hip have a strong conn ec ti on and pl ay a significant rol e in term of tru t within relation hip, how do es th e therapeutic relationship or how is it affec ted by the use of touch ? I think it certainly can solid[fj. 1it in ... because it 's . . . th ere has to be that trust there and.for a client to know that, they're 111 a ' 'ulnerable situation rig ht, o.f releas ing tears . .. that can be a scal)' thing in fl·on t o.l someone yo u don 't know ve1y well, to kno w th at th e H'orld is not{alling 68 apart b cau an b th y 're in tear or that it' aka and it can be a mom ent that often d o I think it can build tru t and conn th rapeutic r /at ion hip .... becau r I a lion in th th y would know [f th y were to th ir motion in that way that it ' a.fe to do that. It bui/dr; as nse of. afi f)' a w II a that, tru tin th relation hip, tru ting that it 's safe, it 's okay, it ' When orking a.fi to do that in this office. ith client h elf-harm , Pam ela cc th e cli ent ac cpting her touch n their arm a , " Tru. I , like a gift. It is part of th e process. It 's part of th e real trust bond in a h a/thy re/atton hip between th e co unsellor and th e client. " h uld he be given a ignal t u h i n t kay , th en I know that th e_v are not th ere yet and I'll help th em move toward it. I continue to work on building that tru ring relationship and let th em kno w that I'd like for th em to be comfortable enoug h to be able to show me what i happening. If I ever pu hit, it is a gen tle kind of thing. he further explain , in regard to tru t within th e therapeutic relation hip, "it 's all about trust. Ifyou don't have trust th en counselling is not as eff ective." u an's experi ence i similar in terms of interpreting trust within relationship a being an clement important for clients. I see it 's more about struggles. Somebody who's, '1-·vho has a lot on their plate, who has a lot that th ey're struggling with um, sometimes they need, they need to have a sense urn, having somebody around who they can go to, that th ey can trust, that they can have a hug from once in a while. ( u an) 69 D borah al p ak t tru t b mg pre nt in r lati n hip with the youth he work with , tating it ' tting right into th eir torie and th er ' that trust th re, th re' that y ou know, of that connection and I, some of th m are in trouble with th law but I'm finding that th ey tru I that yo u know, what th e; sa i , I h ar th em and I to tal~1 re p eel th eir ilences. I don 't tr_v and make th em talk. 1 don 't fl y to make them talk when th ey ar to conn ilent, yo u know, j ust being able t that way and again it started with touch of th hand on th e houlder, th e hand on th arm. o many of our youth are so not g iven that re p eel I think of being able to realize that it ' okay . .. .knowing that level of tru I and where th e relationship i at. Caring in relation ship. Four of the participant touched on the topic of care. Cynthia talk about touch a being a support to reinforce her verbal message of carin g to her client . It 's a behaviour that matches th e word, I care about y ou, the stress that y ou 're going through and just regarding that th erapeutic relationship, that it just brings some, I don 't know if I'm using th e right words but there's that connection. It is through her caring for her cli ents and demonstrating this care not only through verbal communication but also nonverbally on the same plane that relationship can be established and continue to develop . It is Betty ' s experi ence that touch can also demonstrate care, "1 'm going to say I 'm probably thinking about connecting with th e other person showing them the support, I think it 's a d(fferent way of shovt'ing support, 70 tou h i , ah, and on rn and caring," again it i thr ugh thi ge turc f aring that pr 11 id what tty the therap uti rea lm . b tw n cow1 "that in rant connection" and fa ilitate r lati n hip within tty argue , "I think it' one of th e mo t important thing /lor and client i. the r !arion hip, and th e r spect of who ach oth r i , '' rc p ct being an uppl cm ntary lcmcnt f caring. In Pamela ' pcrience her u c of t uch alidate h r arc, With kids that have been cutting, I often a k them if I can ee what th ey've don and if I can touch it. It i. !1ke someone cares about th em ... th ey can tart to r co ni::e that someone can care about th eir healing procer; and o th }'can . tart to car about their own h a ling proce. . In thi e ample Pam Ia a l o u c a ge ntle tou h to model care to youth. ynthia di cu e bri efly that a a th rapi t there i that clement of humanity, "caring is okay. We can be non-judging but you know a th erapi ts we're not unfeeling. " Michael agree that through touch within the relation hip, care i demon tratcd. For him , his experi ence i in re ponding to touch when initiated by the client, and hi or her ubscqucnt interpretation of hi re pon e, "I think th ere's that communication in that understanding and ah care, ... . it 's relationship, it 's um, it's human, and th ere and I think to be um, not sho wing any form of reciprocation um, could be co ld and um, and not caring." Decision M aking Factors Factors that influence the participant ' deci ion to utili ze touch arc important to everyone interviewed . It is complex and multi -faceted, revealin g many categoric . These categories , ju t like the main th emes , help to make up th e canopy of the umbrella. I am writing about th em as distinct factor ; however, they do not exist in i olation. 71 c rding t th nine parti ipant interviewed th r are many fact r that guide one ' n t utilize t u h and rarely if ev r i there merely one factor that i the ole ba D r that d CI n. th participant di cu ed, th d ci i n t u e touch i c ntingent n the ituati n; meaning in them mcnt with each client, from m ment tom ment, a we ll a th en ir nment. pace 111 ach client i differ nt a i ea h e i n with each lient. The hi h y u meet i al th y w rk and th 1r a fa t r a alm ork en ir nment i al i influential n the deci ion making pr ce Body cu t half of the participants revealed where a fact r. Dr aving a therapeutic relati n hip me coun ellor interviewed a well. are imperati e to all participant in a variety of different way . The majority of participant poke about the influence of their pa t experience and education a being influential on their deci ion to u e t uch or not. La tly ethic including ethical guidelines and boundarie played a role for everal participant . Situational. Almo t half of the participant agree that each scs ion with a client is unique a are there pon es participant elicit from each client. Betty points out that her decision to use touch i dependent on each situation , "It 's not something I do with every client every tim e. " Cynthia addresses thi situation, when I do use it, I'm not thinking here's my treatment plan and I should insert a hug at point A , B, and C. I don 't do that. I think it 's more of a response based on what I'm seeing, so th e p erson 's shaking and they're in tears. I'll bring the Kleenex box over to th em, may be gent~v rest my hand on th eir hand, offer them a tissue. I don 't think about it before hand that I should rest my hand gently on th eir vvristforfive second , I don 't. This is more of a natural response to the given ituation. 72 u an di cu d a imilar p n nee, d p nding on th e ituation, dep ending on what was happ ning in the conv r ation and l'vhere omebody wa at, I would om tim qu tion on wheth er or not th J' n wa (. i ) d ded a hug and th en! wo uld give one if it ir d. For u an , it wa important to al hugged a in her ask th e ample. b certain the lient wanted t be touched , or eborah c ncur , affirming, "]think each ituation is different. " Mary poke about h w her u e f touch changed when he changed wher he wa w rkin g. The en ir nment of the two work place in comparison ar very different. he explained th e change, "in this environm ent anyways, it 's just not omething, I ue again from ob ervation or modeling, that I see la o often. I take a lot of that into consideration, depending on th e environm ent I 'm in. " Becau e he has ob erved a difference in work etting, she adapted her u e of touch to mirror that of her co-workers, and th e level of acceptance for the use of touch within that venue. "I don 't get to know th ese people very we!! at this point, so I'm not going to go around hugg ing th em " (Mary). he continue to explain that he will engage a client in something like a hi gh fi ve instead, reflecting "It 's just from my observation and the environm ent I'm in. I think I want to tay just a little bit farther back from that." Relationship. Mary 's experience al o speaks to the importance of relationship in the therapeuti c realm, something other participants also reveal ed. Anne mentions that as her relationship develops, "I can th en give th em a touch or a pat on the back because the relationship 's been developed. " Pamela 's practice is that within the therapeutic 73 re lati n hip he me t under tand her lient and " ou tart to a k qu stion u ha 'wh n) ou wer growing up ... ?" or 'in yo urfamily, how do s thi work?' and 'what is that lik ? '" u an' u c f t u h i dependent n relati n hip, if I fi I lik we haven 't connected I would say probabl ' I would not engage m an kind ofphy, ical touch with that p rson . .. because we're not there w haven 't made that agreement yet and it's okay but somebody who I have fi It that connection , ore tabltshed that connection, I would at least go to that level. I mean it may not happen, it doesn't happen every session, hut (f th er ' omebod.r who is in a place "'vhere it may come up that I would normallyju t ay, 'do you need a hug?' . .. th ere would have to be some art of a relation hip before I would choose to use touch. Betty' deci ion to u e touch al o relic on her relation hip with client , typically th e relation hip has been built somewhat, it 's not omething I do on a first session ... but after rapport has been built and trust has been built then, and it might not be that th ey're not teaJfu/ or upset, but they're talking about omething that's may be meaningful to them. However, a mentioned earlier, touch i multi-faceted in one 's approach to u ing it and the ituation plays perhap an even more important role in Betty' deci ion to u e it as demonstrated by her experience, early in the relationship because th e rapport hasn't been built th e same and the connection isn't the same there, but I also have at the end of a session, and it might be my veryfirst session with someone who has laid out a lot of information and its been a d(fficult se sian, even though they don 't know rne 74 ov rl well, or m th m, although I've ju t h ar th eir whole !OJ) . I would probably ay to th m, '!like to g ive hug, and if th ey would liA one I'd be mar than happ) to. {f th ) don 't I 'd b j u t a happy about that a well, ' 1 and ome of them who it ', been their fir 1 e ion go, 'Oh, thank y ou, ' and th n .,, , ive a brief hug. It ' like validating that it 's aka;, yo u did all that talking and harin . I 'm connecting "''ith you. r client ar 1, r lati n hip i n t a important when deciding to u e tou h, uggesting the n ed [! r t uch i more apt t influence her dcci ion it ' probably not huge when yo u hm e a person coming in th e.flrst tim e and ma 1be th ey're dealing with ome evere p ro blem at that moment. Regardle of not having anJ' relationship with th em in that moment, if th e 1 're needing j u t, it eem like th ey're needing a quick touch or a quick reas urance at that moment when th ey're crying or excessively or any thing like that, I consider it appropriate. Client need. However, knowing when a cli ent needs touch is not always cl ear for Carol who question , "How do we kn ow someone needs it, that 's my biggest dilemma, right ?" Cynthia also con iders the client need for touch when choo ing to use touch or not, respecting a client 's individual needs . . . . mirroring where th ey're at is something that I do, I think, so if they're comfor table and it is sort of a need fo r them, I will respond accordingly and sort of match where they're at if someone is more consciou about their bubble or space. I sort of match or respect th at (Cyn thia). 75 For Mi hael hi d y uth initiat n to engage a y uth with the u e ftouch hinge n whether the th touch "{f th e youth initiate the hi h jive or give a hug . .. th en I'll do that then. " P mela al ore p nd t t uch wh n initiated by the client, " ... p eople will ay, ' an I hav a hug?· and I'll ay. " >f co ur e) ou can, ' and I will." or Pamela, e n wh n the th rapcutic relati n hip i well e tabli hed, ". .. I till don't impose my If on h r but it · ahl'ay t u h nly with lient pem1i E thical co n id eration . omethin that h require orr que t, " he will engage in n r up n their requ e t. e cral parti cipant rely on ethical guid eline and boundari e to determine when touch wo uld be warranted; pariicular concern i en uring th c un ell r ar pra ti ing beneficence and nonmaleficence in their choices. u an e plain , omebod) '.vho 's really distraught, I wou ldn 't automatically use touch because I wouldn't know vvhat th e cause of the distress was. I would tend to then step back from the ituation rather than go ing in to it until I know. I think it 's the whole i sue of safety. Is it safe for the client to go there? And if I don 't kno w where th ey're at, I wo uldn 't go in to th e situation assuming that touch is the answer. I'd have to know, I'd like to know that it wo uld be received in the right way by the individual. Carol mentions how strict the ethical guidelines are for her profess ional association declaring, "that is th e big one that obviously as a (counse llor) I have to abide." In addition Carol addresses the ethics that guide her practice and the importance of practicing with beneficence and nonmaleficence when she talks about the "intention to make it fe el all better. I think it 's comingfrom the most ethical part of our job ),t•hich is 76 to help client , ri ht? o, it ' coming from the deci ion making around u in what we have, any tool , any kill , any interv ntion to h lp th em out. " Michael al o i oncerned with int nt and wanting to "be clear VI hat th e intent i , " for fear f "don't want it to b mi con tru ed or mi ~judged. " Fr man thical tandp int Michael ' concern regarding hi eli nt and h in g to u e t uch r lvc ar und being tran parent ar und th deci ion making pr ce ngage in t uch . If it ' un aD D r either him or hi licnt, "it' not 1-110rth taking th e ri k, afety to m i really important and ?f th ere's any indicator that it ' going to be misunderstood or create i ue , th en I think not to do it, " thu ech ing u an ' concern for th e afcty f the cli ent. ar 1 further explain how profe ional thic fact r into her thinking wh n deciding to u e touch , "They're pretty broad. Th ey leave u a lot of room for thinking or deciding but, I think they're helpful in general. It is good to have ome idea around how far we can or should or shouldn 't go. It 's a reminder that touch can be helpful but also very harmful. " Body cu es. One thing mo t participants agreed on is the importance of being in tunc with the non-verbal body cues of the client while in es ion to determine whether they would choose to u e touch with that client, in that moment. The counsellors intervi ewed interpreted their own ability to decipher a client's need for touch was influential on their decision to utilize touch or to withdraw their touch. Interpreting the cue that touch would be warranted is secondary to being aware of one 's body cues and thus being able to decipher their meaning in the moment, "{f I don 't intuitively feel it would be okay then it would have to come from the client," Susan says. She ' aware if her own interpretation of her own body cues is not sending her a signal that touch would be appropriate he would not engage in touch unless the client specifically asked her to . Anne also poke to 77 body cue when engaging in the deci i n th intuitivene of interpreting her eli nt making pro e tating "it ' so natural that my thoughts ar automatic . .. th er 's no r a! deci ion that ou 'r making, it 's j ust a natural occw-r n "I'm awar of th ir bod cue for me. " Y ct he tate , if omeone goe ri id I am aware that that ' not what th ey ne d at that tim e. " Pame la i al o aware when b dy langua ge uggc t t uch would n t b w 1 orne "ff th )' how an ' kind of i n of not v\'anting that to happen th n I don 't do it . ... any body languag and kind of aver ion, eye aversion or an kind o.f sig nal that I get that ' not con?fortabl fo rth m th en I wouldn 't do it. " When pea king about body cue he ob rve u an refl ect , th o e detail I'm not even ure becau e a lot of that happens so quickly. So that you pay attention to tho e nuances, I would ayfor me it 's p ro bably in th e, and I '11 go back to what I said before, it 's probably in th e energy, you f eel th e muscles tensing, yo u fee l th e whole p erson tensing, y ah. Yet for D eborah, he talk of, the subtle clues of th e body, body language sp eaks so loudly [[yo u 're in tune . .. I think a lot more with the s ilences of being present with th e youth and reading their silences, reading their body and putting it all togeth er. When getting the message to back off Susan spoke about th e fear or anger he ees on th e client' s face n the form of "a furrowing of th e eyebrows, and squinting eyes" telling her touch is not what the client wants in that moment. D eborah de cribes her experi ence as, when I work with kids, !find out what kind of touch co n~forts them and usually stay with that. It 's again, like I say, watching their response, sometim es when it 's a little too much you know enough and when to pull 78 back and th t n ing I find it ' th body ten ing, maybe a little bit of the j rk pull away, ubtl pulling awa e pecia/1 ifyou 're touching c/o eon om thin you reali=e th r hasn 't been touch but you ee their body puffin awa) from you or during th e discus ion and yo u then, that's not th e be t tim e to have that phy ica/ onnection Vl'ith th em. The e e p rience p ak t n t only the importance of being ob crvant of client b dy language and being able to accurately interpret it when fir t chao ing to u c touch but remaining c 0 llizant f b dy language thr ugh ut the t ueh h uld a client be uncomfortabl r chao e ton I nger want that type of contact. "Obviously [f th ey back off that ' a clue, " ( ynthia). Pamela poke about here pcrience with client who a k for touch uch a a hug at the end of a e ion outlining how he know her client want thi interaction, "th ey'll g ive me a clue, a verbal clue or th ey '!I open their arms, so a body lang uage clue that that 's what they want." u an ' experience is similar to Pamela 's stating she would "probab ly look for some sort of instigation on the part of th e client. " Mary describe it as , "I think they 're kind of sitting in a place where th ey're not all kind of curled up in th eir chair, they 're kind of open, when she knows a client is more apt tore pond to a high five. II "If they say yes and I'm sure I can see it in their face, if th ey willingly cooperated and vvere engaged in that process, I'll g ive them a high jive at that point. " Deborah agrees that body language and interpreting body cues play a vital role in her decision to utilize touch with youth, "It 's important to watch subtle body language, read cues, start where the client is comfor table. II Betty also takes her cues to use touch based on "their comfort. th e way they express themselves, how th ey're looking at J'OU, or not looking at you. " 79 end er. the intervi w pr gre ed In t d in my r fle i e joun1al, "one inter ting n te i gend r, t uch i being u ed far le eli nt . end r diffl renee i not with mal client than female mething that cam out of the article I've r ad." me pariicipant n ticed up n r fl ecti n f their u e of touch that th y u e touch m re with fl mal cli ent than mal client ( nne, Pamela touch with youth hildren and mal uth , etty). When comparing her use of nne tated "I use it more with female than . . . I don 't know ~f I touch a much H'i!h the older male . . . . I might not use touch a mu h with th older mal .. " e plaining the difference with male youth in term of "boundarie ,ju t b in aware pro_fes ionally. Would it be accepted a. much? I don't know, o a ain reading tho e cue . " Anne goe on t talk about th e importance of being aware of a eli nt ' body cue when ch o ing to u e touch · however, heal o note with male youth he i acutely aware of the need to maintain boundari e for fear of being misinterpreted. The e component play a role in her decision making process. Pam ela does not ever hug boy reading the body cues from male youth , "I don 't get that vi be that th ey want to be hugged." While Betty hugs male clients le s than female clients, he states, "it did get my th ought provoked on what I do and don't do, and then that' when I realized I don 't do it with males very often because it's just a different societal thing I believe. " She continues to talk about her experience of wanting to hug male clients under similar circumstances she would hug a female client, yet he would not do so. he questions the fairness of seeing a female client with whom she feels touch is important and she do es use touch, then eeing a mal e cli ent who may need the same kind of caring touch and not provide it. For Mary and Carol, gender did not have any influence on their decision to use touch whereas Susan, Deborah and ynthia did not comment on gender 80 diffi r nc . Michael didn t comment about u ing t u h m re with one gender or an ther; ho e er, th boundari e p ke of influ n e Mi hael nn p k e f and the fear of mi interpretation Pam la deci i n to engage in t uch with fema le client . He ay , "! fi 1 mar confid nt in r adin the ituation a a mal with a .female initiating touch that ' for ur . In th be inning I was mayb a bit anxiou .. . now I 'm bet! rat b ing abl to manag it b tt r. " He hare a t ry f wa h itant t recipr ca t fema le client initiating a hu g and he ut f rc pect for the client. H e wa he itant becau e of th e fi ar of mi judgment f hi intenti n, the tigma n t t have contac t and concern the eli nt may n t return . making pro e or me participant gend er clearly influ en ces the deci 1on and the bounda ri c , ocictal va lu es and perceived intent that accompani e it. Past experience and edu ca tion. Par1icipant pinpoint the va lue of past experi ence and education and th e role it play regarding hi s or her decision makin g process. For participants, pa t experience appertain to deci ion making just not in the rea lm of coun elling and counselling exp eri ence but also his or her past experiences when growing up. Anne talks about, growing up experiences, touch has been a helpful thing with something that 's been more natural in my life so for me it 's a natural type of thing in life, in general probably from when I was small and pa t training, a combination of all those things . For Alme, the use of touch in her practice i something that comes to her naturally, not just from her growing up experiences but also from her training in a previous helping profess ion. Deborah al o revealed her experience growing up and that what she wa 81 taught thr ugh r garding her family alu practi with play a role in her deci ion to u e t uch in h r uth that wa in rain din m . o it i natural f or me to be that way with my childr n, H'ith childr n I come into conta t with, and with th e y outh I work with . . . it ' j u t a teaching I grew up with . .. it' for eign to me to not tau h. to hav that connection. u an gree he ha "grown up under tanding th e connection betvv en th e mind and body" and b cau Betty declare h of thi he i m r ob ervant of where her client carry th eir pain. "a touchy per on " and accredit her u e of touch in her practi ce to how he wa rai ed. For her it "i who I am . .. . th e bottom lin e is it lets me be me. " Whil Betty talk ab ut her u e of touch a being a part of what make her who he i , it i clear that not only her experi ence growing up but also her year of experience a a coun ellor have al o he lped to shape her practi ce. If I think back, this, I mean I've been doing this a lot of years, I think in th e early on years I wouldn 't have touched. I was younger, now I'm an (X) year old woman who may be has a bit of a different kind of liberty or different kind ofum , I mean as a young woman, it might have been seen or f elt different . . . now most of my clients are younger . .. if I had touched I would have f elt more. as a younger woman, that could have fe lt like a come on or, it 's different now that I 'm older I think . . .. I um, in my belief that a mother who is responding with concern and care um, and I was raised with touch so I g uess in my exp erience uh, moth erly means those th ings, attentive, um resp onsive, in that manner, caring, nurturing. A sh{ft came 82 about a m confid nc grew a a coun ellor um, and my a se sments of 1i nt . I ma b began to tru t more ju t through p eri nee. I don 't r m mber 1vhen it hifted . .. and th e xperienc of knowing what it ' like in e ion and what peopl are like. That 's omething that you develop and it dev lop over time and I mean I'm not alway bang on, yo u know, I m ani make mi take., but] think it' becau e I've done this for so long no w that mayb I 'm trusting my e(f more. u an bared an perience when touch wa not well received by th e client. about thi e perienc in r lation t h r own e perience. he peak he de cribes what thi e perience wa like for her and continue to explain how thi experience changed how he manage her u e of touch with colleague a well a how thi s experience ha mcrea d her awarene of her touch behaviour with clients. I felt really, really bad because it was my fault. I had not um, I had not re p ected her boundaries and I should have um, and in terms ofyah, so I guess that 's th e best I can say, you know, I apologized to her right away and um, it just y ah, it felt I felt pretty stupid, ah, I should have kno wn better, but I grew up in a yo u kno w, sort of in a tim e when we didn't have as much, like I said before, I haven 't had enough experience with um, with abuse prior to this so, I had a little bit of a fortunate um upbringing I guess right, so little bit sheltered, so it was a bit of an eye opener for me. With my colleagues, I 've actually said to all of them, 'I touch. Ifyou 're good with it, let me know, 'because I will say you know, 'how are you doing?' and I will put my hand on an arm and I'll put an arm on the shoulder and um, I don't 83 pi k off lint an more un! I a k p rm1 ion to . I've 1 arned that. Because I u d to art of wipe a houlder or omething but now I 'll ay, 'Are y ou okay with m , ' ou know, 'j u t wip ing the fluff offyour back?' But I do announc it with th p ople I work with. I, o I say, 'I am a toucher so if ) ou 're not ood with that let me kno'rv. ' I H'ouldn 't have a need to ay that with a client becau e I 'm in a diffi rent setting so I'm mu h more consciou of 1?7) own b haviour o I don 't do it with th em a F r Ann uch. when he hanged ca reer fr m an th er helping profe i n to her role a a coun ell r, he no ti c d a hift "I th ink touch wa very natural in that part of my career . .. touch chang d a lillie bit when I went more into a counselling ro le . . . it 's more emotional tau h. " Wherea for both u an and M ary, they became more a ware of th eir u e of touch and the impact it ha on other a th ey received more training and education . about how her awarene usan spoke changed form when she wa working with small children to her recent practicum experi ence, putting your hand on th eir back to comfort th em, to support th em, to j ust tell them that y ou 're th ere if th ey 're having difficulties. Th at was something that I didn 't even question doing at th e tim e. To my most recent exp erience, which was in my practicum where you know I was working with teenagers where actually I, having done the training in th e last few years, was a lot more aware o.f what I should and should not do, that touch was instigated by the students th emselves, it was requested by them . ... that was part of my learning experience as well so I p ut th e fo llowing y ear, I 84 p nt a lot mor tim bein aware of and getting to know a !itt/ bit mor ba kground hi tmy and a/ o being very, a lot more careful about how, how I wa approa hin th individual in th Ia room .... I 'm so much more aware of the p ot ntial on equence . Mary re pr ce unted h r e perienc of how more edu cation influ need her deci i n making a ell a her awaren a , Ju. t f rom what I 've a a in watched in and obsen •ed and seen modeled, touch wa d fi n it ly not . omething th at wa looked um, that was used or appropriate. and a I went thro ugh more choo ling um, I co uld under land how touch co uld be interpreted in d{fferent ways um, fo r the client. So, now I kind ofju t u it a little bit more um , well, I 'm pretty self-reflective when I u e it . .. I think with j u t more edu cation too . .. my bachelor 's degree . .. it wa n 't a whole lot p sychology, and it wasn 't counselling so with more edu cation I think I started to understand and I think it was about, !forgot who 's my, who started talking to me, I started to gain more awareness about ho w that impacts the oth er p erson. This chapter explored participants ' experi ences regarding th e ph enom ena of using non-erotic touch to demonstrate care. Participants described how th e major themes of communication, relationship and decision making factors influence their use of nonerotic touch in their practice. The following chapter examines the existenti al th emes in relation to the participants' experience of using non-erotic, lived relation , lived body, lived space and lived time. 85 hapt r Fiv : Liv d i tcnti al th m h r ar D ur f hi tory, cultur ap r n p n nc r xi tential of Lived Experi ence th at con mi c tatu and und r tand hi (r lationali ty) li cd b d i t r arc c idcnt in human phen m ena rp rea li ty) li which provid e m eaning t th e way r her lifcw rid a being real. ivcd rclati n d pa c ( pati ali ty), and li ved time (temp ra li ty), ar uni vcr alli .G w rld theme thr ugh w hich every nc ha li ved e pen en van M anen , 20 14). The c i t nti 1 th em how ver, th e d n t i t in i lati n t arc addrc cd indi vidually; nc an th cr. It i th e urn f th e .G ur cxi tcntial theme th at crea te th e li ved w rld r w h lc of one' c pcricncc. Th e eparatcd a p cct of each e i tentia l w ill be tudi d whil e at th e arn e tim e reali zing nc ex i tcnti al call f th th er . The way in w hi ch each ind ividual experi ence and thu crea te meaning in term of th e c li ved ex i tentia l crea te immense di ver ity and multifariou ne through interpretation of the Ii fcwo rld . ach experi ence can be interpreted through th e exi tcntial and each experi ence crea tes uch uniqu e meaning and variety not ju t between each individual, a lso between each indi vidual's experi ence . It is throu gh th e interpretati on of each of th e indi vidual exi tenti al that th e true e ence of one's experi ence is revea led . W e can ask of one' experi ence the fun damenta l que tion that correspond to the li few orld ex istcntials (van M an en , 20 11 ). Hermeneuti c phenomenological research is exp loring the complexity of th e human li fcwo rld and examining th e th eme or th e structure of meaning of lived experience (van Mancn, 2007). The lived exi tcntial th at arc examined in th is chapter arc not to be confused with the th emes of th e ph enom ena of non-erotic touch u ed to demon tratc care. 86 Lived elf-Oth r (Relationality) R lati nality or li ed elf- ther relati n i "the liv d r lation we maintain with other in the int rp r nal pa that we hare with tb m ' (van Man en, 2007 , p . 104) . We appr a h th r p opl in a b dily way uch a when we greet one another with a hand hak r tlu· ugh th impre i n we form ba ed on how he or h i phy ically pre ent. Regardle f how we fir t bee me a war fan th er per on, whether it be through dir ct or indirect c nta t we have created an idea of what he or he will look like; hi or her h r h r phy ica l appearan e, hi r her phy ical being that when we do meet him r he may or may n t b what wa envi i ned. nee we meet directly we expen nc an xi ting connection through convcr ation, which allow u to urpa lve . In term of e i tence human kind ha our earched in thi experience of the other, th e common e p en ence bared by all, connected by a en e of purpose in life, meaningfulness a foundation or rationale for living (van M anen, 2007 , 2011) . Van Man en (20 14) explain the theme of Relationality a a guide to observing how phenomena are studied between self and other, querying how peop le or thin gs are in associated with one another. How are we experi enced in relati on to others? When examining the use of non-erotic touch, relationality emerged as a major theme. Without relationality, the phenomenon of using non-erotic touch to demon trate care would not exist. For Pamela, "in the therapeutic process, your relationship is everything", Betty agrees, "one of the most important things betvveen the counsellor and client is th e relationship." The very act of two people connecting through touch i corporeal, being present with one another in the moment. Once the coun cllor and client meet, th e relationship begins to develop beyond the image or imaginings that were 87 fl nned pri r t fir t face-t -face c ntact. conv r ational relation hip is formed wh r communi ati n ma b talking ab ut th u e of touch or communication may be through the a t f t uch within th therapeutic realm. r tricti de h u f t uch can allow triumph over a pe t of poken language in rder t communica te under tanding and l p intimae within th therapeutic rclati n hip on a different plain than what can be tabli h d ith w rd alone. Th deeper rclationality can create a shift in thinking that a eli nt n ed t r tri t emoti n in rder to be comf01iable and afe while expre ing hi or h r fe ling . It i thr ugh the rela ti n hip , fo tered through the u e of touch that the coun ell or the eli nt to realize or become aware of his or her purpo e in life or awarene s of the meaningfulne f life. Through touch th me sage is "I care", meaning you are worthy, you matter to me, you are important, you are omebody pecial, you count. The me age, "I'm here, I hear you, you're not alone ( usan)" is portrayed. One could question through lived self-other (relation) is it pos ible that through the use of touch both the client and the coun ell or are searching for a sense of purpose, or meaningfulness of the experience? While the counsellor may not need the touch, van Manen's relationality might question does it enforce this message all the same? How is self and other experienced with regards to the use of non-erotic touch? The touch experienced is the phenomenon and would not exist without relationality between self and other. People are literally coru1ected during touch regardle s of type or length of the touch. Ethics plays a paramount role within the lived relation as it provides containment in ten11s of the therapeutic relationship and the boundaries of this relationship. It is through touch people are c01mccted. 88 r ow th elf i ar h. It i n e plicit a peri n d in thi r lati n wa n t wholly elucidated through my mp nent f th ph n mcnon that many participant were unable be ut. When nne a ked about her wn feeling and how he experience th t uch, h repli ed ' I do n 't kno\V actual/;, it ' j u t a natural, a natural instinct, it ' a natural con?fo rt, fe ling that ' what th y ne d, I g uess." Pamela al n v r r ally th oug ht abo ut that." ex pres ed, "I've ynthi a' e peri encc arc more in line with Anne that h d e n ' t think ab ut t uch "actually not at all, more of th at intuition." additi nall r iterat d, "I do it . o in tincth ·e/y. ' u an mcwhat incongru u to th e e e penence Betty acknow l dge her in tinctual en ati on , "it j ust.fee/.r; right . ... it f eels goo d but I don 't kno H', I do n 't knmv hoH.' to de cribe th at," yet cannot full y illuminate how he p ri nee her elf full y. arol ackn ow ledg the self in a more intellectual en e " it fee l all ricrht, tt ' j u t like, I 'd ay, like most oth er interventions whether it ' touch or verbal or any th ing else. j ust fee ls velJ rewarding because yo u helped someone." Carol and Betty acknowledge the thought of tou ch bein g ri ght without acknowledging their meaning of the touch . Without the therapeutic relation hip between counsellor and client, caring through touch could not exist in th e true physical sense of two obj ects resting against one another or in contact with one another. The demonstration of caring is perceived through the tactile sense. Many ph enomenological researchers regard the relati on hip as the primary theme of their understanding of human phenom ena (van Manen, 201 4). Through analysis of interviews with participants it was revealed that relation stands out as being pivotal in regards to the phenomenon of touch . Touch is used becau e there is an establi shed relationship , "I wouldn 't arbitrarily go out and use touch without having 89 ome art a_( relation hip ( u an) .' T u hi al o u edt fo t r tru t within the relati n hip it ' a differen e, it' a en ation, o th ere' th e different en e and a u e of n e with om bod o I think it changes the relationship, but I think it 's ubtl . It ' tru. ting . . .. it creal s trust . ... body communication, body language but th er ' that contact, that communication, tru t through touch (Michael). Pamela u. e touch a an aid in de eloping the therapeutic relation ship , " it do e kind of olidify th e th erapeutic relationship a bit. I think if th ey fee l comfortable enou h that they can tru t thi H'ill ju t be an honest hug without strings attached . .. it 's all about tru t, right?", it i in the pre ence of the other, th e cli ent, that th e experi ence oftouch, th e phenomenon with lived relation can be studi ed. It provide that deeper connection between elf and other. How i the relation between elf and other experi enced in counselling through other' stories? Participants spoke about acknowledging the power differential and the importance of being aware of this imbalance, I'm hoping that it kind of evens th e playing or has them feeling that it evens the play ing gro und . . . it's just a sign of respect . . . kind of evening out maybe urn, leveling th e playground, like yo u know what I mean so it's urn, like the power differential (Mary). Participants spoke about their own feelings of satisfaction and w hat i expressed as feeling good due to a sense of helping clients and making a difference for them . 90 I think they get a !ranger connection . Th ey f eel/ike y ou 're really invested in th m a a p er on and what th y 're ay ing. I think that can increase, I think it ' mainly abo ut th connection and that um, may be a sen e that I appreciate what th e) 're going throug h and we're wo rking tog th er (B etty). Anneal o aid, it ' g reat. I'm art of experiencll7g th eir excitement too o we're both recogniz in . .. I th ink it fe l goodfo r th m, it fee l good fo r me that we are recogni::.in an a compli hment or something th ey've done well contribute to th at re lation hip . Touch i fundam entall y a relational experi ence, wh ether it is examined between coun ellor and cli ent or not Wh en yo u start to get to know people, in a th erapeutic relationship, you can begin to ask questions such as 'when you were growing up in your family, did p eople hug or touch much?' and 'what was that like fo r you?' (Pamela) . When a ked about any di cu ssion between cli ent and herself regarding touch , Ann e responded, "rarely, it 's non verbal body cues, " whereas Betty is forthwith in her discussion with clients, "I like to g ive hugs, and if th ey would like one I'd be more than happy to . If th ey don 't I'd be j ust as happy about that as well. " However, it is worthwhile to question when th e use of touch is not di cussed verbally does it become secret-like? Without confirmation from the cli ent, the counsellor trul y does not know the cli ent 's understanding and perhaps the cli ent do cs not understand himself or herself while the intenti on is not shared. Th e experi ence is bared but th e 91 int rpr tati n will und ubtedly ary . Thcr i a en un 11 r nd li nt h n t u h i utili zed · di cu f bar d intima y between i n r c nfirmati n about the t uch ' th int nti n fl r t u bing, and th pcrcei ed meaning can break ten i n within the h ba lan e f intima y i already ne id ed a the c un e ll r com e to kn w intima intimate th ught and il ling f the cli ent, and tou h can either break r lace a ce1iain t n i n in th li I arl th e ph en men n f u ing t uch wou ld not exi t ith ut li and qu ti d d r latJ n . lf- th r. It i thr ugh thi relati na li ty th e ph enomenon ex i t to tudy nn cc ti n , th elf in li ved relati n to the th cr. Lived Body ( orp orea li ty) one human me t an th r human, it i through th e body that ne com es into th e pr ence of anoth er. It i thr ugh th e ph y ica l elf m ethin g i reveal ed to anoth er yet al o preventing full di c lo ure of e lf at the arn e time, neith er kn ow ing ly nor intentionally. Wh en one' body beco me m ethin g anoth er hum an begin s to stud y or ob erve it may no longer m ove in it natural, intrin ic mann er. Th e movem ent and th e tate of being i now heightened and m ovem ent lose th eir natural way. Th e body lo c the intrin ic movem ent a th e body becomes aware of each movem ent; it m ay appear or become more foreign , uneasy, or les graceful (van M anen, 2007; 2011 ). The participants spoke abou t th e cli ents' ph y ical body, in parti cular bodily cue and th e interpretation of body cues " ... I'm sure I can see in theirface like [f the_v willingly coop erated and were engaged in that process I'll g ive th em a high.fi1·e at that point (Mary)." D eborah a l o watches body cue , " ... important to '.1'atch ubtle body lang uage, read cues, start where the client is con~fortable . .. ". An ne i al o in tu nc to her cli ents' phys ica l body, "I'm just aware o.f their body cues . ... any body language 92 and kind of av r ion, e av r ion or any kind of ignal that I g t, that 's not comfortabl forth m th en I wouldn 't do it. " The cli ent thu revealed omething about him elf or h r elf thr ugh hi or h r b dily pre cnce; therefore , it i thi b dily pre ence that allow the ph n m n n f caring through touch t be experienced ~ r the ubjcct and the object. When neb c me acut ly aware of one' body and no longer move with ut the uncon ciou , in the m ment awarene and thought beyond what is intrinsic cau e on e to be in tun to the polarity f reacti n to touch . orn e p op le 1-t'i/1 want a touch. Th ey want a hug but they are really uper rig id and oth er p ople will j u melt right into you . . . [fy ou 're op en, [f y our aH ·ar ne 1 open you can p ick up little signal fr om p eople that th ey are mi ing that omehovv. Th eir bodi e g ive you so many ignals about what 's go ing on, H'hat ' not go ing on (Pamela)". Anne relates the di imilarity to relationship "some p eople may have been rig id or have th ey, as th ey get to know you it might be th ere I can th en g ive th em a touch or a pat on th e back because th e relation hip 's develop ed. " Counsellors and cli ent have different opinions about the use of touch as well. Some clients relax, become more at ea e, have a softening, and lean into the one providing the touch . Others become tense, ri gid, have a bold glare and furrow ed eyebrows. I think it 's usually, it 's received p os itively simply because of th e energy that sort of comes back to you. In a hug it 's a question of whether or not th ey actually, the lean in to you as well. Do they reciprocate [fit 's a touch on th e shoulder or something. Do th ey look at you and receive th e message, as it 's intended ? I would always look for th at if I sort of, and I th ink these are 93 ome of th me ag that are ort of hard to put into word becau e you put our hand on omebody' houlder and you feel the back ten e, or you fe 1yo u, th y give a look to sa what are yo u doing woman, um yah you \·v ould pull ri ht o.ff right? o,) ou li ten to that, you have to li ten to that nergy) ou have to alwa) be aware it is being received in th e way that y ou want it to b receh ed ( u an). Thcr were p lariti am ng t participant a well, fl r example one u c touch openly; wher a , another u e t u h cry little or not at all. arol tate , ... u ed mainly when th e clients are in severe di tre s when you really, really feel th e; need that rea urance or to get calm for the moment, clamed down from what th ey are experiencing emotionally so that will be a really, really gentle touch on th e hand or a shoulder . . . For Betty, her xperiencc i so mewhat different, what I've learned i if someone is experiencing a lot of emotion and th ey're crying, in touching th em it distracts th em somehow and maybe it does make them feel better and th ey feel connected but th ey disconnect to th eir strong emotion. For participants the awareness of having the body observed, of knowing omeone 1 watching was manifested during interviews for this study in the awkwardne s I observed in them when I asked about their experiences, I'm very intrigued by my observation· of many of the participants. When asking th em about th eir own experiences of using touch th ey pause and appear to be thinking about incidents when they have u ed touch. I sense 94 an unea or awkwardn s alma t, a though I am revealing a part of them that i not talked about, ore posing them omehow. I can't help but wand r if thi relat s to the literature about coun ellor, not talking about th ir u e of touch for fi ar of being crutinized. u an ame t an awarene of herself upon r flection , "Until I tarted talking now I didn 't realize how much I do u 'e that (touch) ". What then i the c rporeal e perience in regards to the phenomenon of touch? Van Manen 2014) que ti n whether the b dy i paid attention t . How and when i the a war ne of th body realized? During my interview , the participants were unable to an wer enqmnc about th ir own body re pon es to touch. Many answered as Pamela did "I've never really thought about that, "or like Anne who started to think about it after receiving her invitation to participate in thi study, " ... when I was asked to be part of this study I tarted thinking about it and thinking about how I use touch with clients. " Yet the body i central to the phenomenon of touch because touch itself is two bodies or parts of bodies in direct contact with each other. If someone is tensed, or their emotions surface I see a softening, so if they 're holding th emselves tense and they're temjul and th e touch is used when it 's a hand on the shoulder or if they've had a particularly hard session ... I see a sort of a softening, a physical softening, sort of a release where they 're not holding their body so tense. It reaffirms that sometimes they need something more than words and that simple gesture can be helpful in relieving the stress (Cynthia). Deborah has similar experiences with observing client body cues, 95 I ee a relax ing of the body, when ome do re pond to the gentle touch and y ou j u t art of ee th eir bodie relax and if th ey're holding th em elve tight that ' when ... you can just fee l their body r Ia - and th eir breathing change, of th em actual/ re ponding to you in that manner . . . y ou ju t see th relaxing on th eir fa ce and most!) th e breathing, that kind of more relax d po ture. Int re tingly pa1ii cipant wer fa r m re mindful about the li ent' body in the ability to e r ad and interpr t body ue a menti oned than with their own corporeal responses, reaction or e p ri en c . The body of elf and the body of oth er arc perceived very differently ne with compl ete awarene , the other virtuall y unaware and appearing without thou ght. When Anne wa a ked about her own corporea l experi ence after om e reflection he re ponded "I don't know actually, it 's j u t a natural instinct, it 's a natural comfort, " and Deborah concurred "It 's always hard to describe." Many participants were unaware of their physical or corporeal responses to touch and therefore, unabl e to speak to how they experience being touched. Those who comm ented on it had something to say very similar to M ary, I think I fee l less tense . .. I notice 1 do sit up a little bit more straight, my shoulders go down a little bit more, I'm a little bit more relaxed. I'm not intense, or intent on kind of what, what was go ing on. So , I kind of op en up agam. The phenomenon of touch would not exist without lived body which is of intere t when participants admit to not paying attention to their own body cues; however, once it i brought to the forefront of their awareness it elucidates the experi ence, brings atten ti on to 96 tb parti ipant indi idual e pen nee much like van Man en li ed b dy and h w th in tinctual m vem nt until it i brought to th £ refr nt f one (20 14) explanation of ne make are ex cuted without thought c n cwu ne I didn't r a!ize hoM much I do u e that . .. (. u an) ". " ... until I started talking now, referenced in van Manen (2014), artir n te , "the b dy tend t be e perienced as pa sed over in il ence (pa ilence) ' (p . 04 , and thi ' ou true£ r many of the participant . Lived pa ce ( patia li ty Lived pace i 'felt pace" (van Manen 2007 p. 102). One may think of pace as a di tanc t be travelled r li e m thing to be mea ured uch a dimension of where one uch a an apartment or hou e. Lived pace however i not as definitive a a numb r r m a ur ment. A with lived body the experience of lived space is not generally reflected upon; however the space human occupy, a in a counsellor's office, can affect feeling and motion. Lived space experiences are influenced by the space a body occupies uch as a large multi-story foyer can create feelings of being small, whereas sailing on the open ocean may induce a sense of vulnerability or insecurity or even wondennent and awe. Human experiences are shaped dependent on the space in which the phenomenon occurs (van Manen, 2007; 2011). To understand the different experiences, questions about space are asked, questions about home, school, work and extra curricular activities. Spatiality defines experiences about phenomenon and the quality of meaning of the experience as it helps to differentiate the individual. The absence of these spaces thus provides a deeper richer meaning as being more than a loss of space but the absence of a sense of belonging, safety, or even a sense of being. The 97 e i tential th m f li ed pa e al addre e the c ncept of home or being at home ( an Manen 2 07 2 11 In thi tud r 1 f the parti I pant compared different job an d work paces pcnen whi h influ n d their om in tan th d1ffl r nt u ed but al h th r t u h wa u d r n t. Th when ch philo mg t u f d m n trating care thr ugh the u e of touch. In rk en ir nment influenced not only the type of touch t u h. The li v d pace, ccupied by other profe iona ls and h w tru t 1 phi rea tcd with client and the ro le touch plays in fo t ring that tru t. The th r fa t r parti cipant li ed ac 1 th patiality influence the comfort level pa r ph ical pr poke to in relation to the theme of im ity between participant and client and naturall wh n t u h i utilized th lived pace between two people is reduced to nothing wher th t u h ccur . I don 't think it· like ( naps fingers) instant like I could sort of see th em, that they 're di tre ed ad that I need to intervene. I'm responding to th em. I'm not ju t going to it here cold and just politely wait until they're calm ed down o I might move my chair closer to th em. I'll often do this (wheels chair closer) yo u know wheel my chair over, and th en I'll lean in (Cynthia). Van M anen (2007) speculates children may experience space differently than adults due to an adult's advanced understanding of social character and social and cultural norms associated with space that gives space a qualitative dimension . Van Manen proposes the space needed to feel comfortable or intimate as an example, which give rise to an added dimension of touch in its use for teaching or demonstrating the societal or cultural non11 to youth . For some participants the space needed to feel comfortable 98 uch a b undarie "... ju t boundarie , ju 1 b ing aware re d around pa profi ionally . .. and a! om boundary a w II (Anne)" and physical proximity a m nti n d by nthia ab e. 1 arly the participant ' comfort with pace wa evident depending n the type oft uch utili z d. pa e r di tanc betwe n tw p bctw en full b dy hug i an intimate ge tur where the ple i literally n n-exi tent. When the lived pace i un ellor and client within the confin could intimate th arc cl of an intimate therapeutic relation one eon an m tionallevcl which i a more ab tract mea ure of pace ... !f I'm reciprocating a hug I'd be really careful a_[ that, ho w I respond, I would one arm and keeping m) body more open, it's a one foot back, not bothfeetforvt·ard, it's a one houlder back o th ere' an open stan ce . .. where it eem appropriate or initiated by th e youth especially that ' where I feel more comfortable. I'm pretty conservative with touch ... but if the yo uth initiates the high five . .. to give a hug or a youth does that, and it's just like a good-bye um, arm, um th en I'll do that. I wouldju t do one arm to meet it or match it, just by contact . .. it's a sensation so there's the different sense and ... so I think it changes the relationship, but I think it 's trusting. (Michael). Alternately a touch such as a high five requires clo e proximity and a sen e of comfort, yet possibly not as intimate or as close a relation hip as two peopl e hugging. For many of the participants comfort within the relationship is connected to gender '· ... and I don't often hug boys. I never actually hug boys. And they don't, and I don't get that vi be that 99 th Y want to b hug d . .. (Pamela)". Anneal o recognize that gender plays a role for her comfort 1 vel I u e it more with female that male ... I don't !mow if I touch as much with old r mal , probably not o probably would be more giving a Kleenex or um , ju t eye contact, thing like that I might not use touch as much with th older male . Betty too noted her c mfort hanged with a ma le client, " . .. very rarely do I, have I touched like on th e knee or omething a male client but it's rare. " It wa not only the female participant who noted th ir comfort with the opposite gender, the same was true for the mal participant when working with a female client "I feel more confident in reading the ituation a a male with a fe male initiating touch that 's for sure, beginning of being vel'), maybe a bit anxious or worried." Van Man en (20 14) peaks about space interiorities and exteriorities. The phenomenon of phy ical proximity or touch between two people is experienced as exteriority whereas a feeling of closeness is experienced as interiority. Participants ' experiences of space as interiority and exteriority are varied. As revealed by participants when experiencing the phenomenon of demonstrating care through the use of touch , communication is a major theme. Communication through the act of touch, sending a message of you ' re safe, I'm here, I care, is an interiority. Whereas alten1ately when a counsellor communicates or talks about touch with a client this is experienced as an exteri ority. 100 i a fi ling nd therefi re hape pcopl rna al b haped b intima yet the pace between two peopl relati n hip and fo tering an und rstanding or dcm n trating ar I H'ould ay car . but it · a ge, lure of car in so I think it art of brings life to th e H'ord . .. it ·, th b haviour that matche th e word. I care about you, I are about th e , Ires. that you 're go ing through and just regarding that th rapeutic relatt on. hip th at ... yah. that 1t j u t rings some .. . I don 't kn Oll' if I'm u, ing th e rirz,ht word.. but th ere· that connection . .. I think it ertain(1 · can olidt(y it hecau e it ·, th ere, has to be that trust there and for a client to kn Oll' th ey 're in a vulnera ble situation right, of releasing tears that can be a ary thing in fro nt of someone yo u don 't kn ow very we//. To knm1 · that th e world is not fa lling apart because th ey're in tear or that it 's okay and it can be a moment that can be softened in that moment so I think it can build tru t and connection in th e th erapeutic relationship (Cy nthia) . For u an I could not imag ine doing that work without having the ability to have some type ofphysical contact. Th ere is so much unsp oken that happens in the touch that I don 't think I could convey -..1:ith language . . . the healing p ower of touch is, I mean it 's huge . . . ify ou translate into th e power of a hand on a shoulder on an emotional level if you translate that, it 's enormous. I mean I have full belief the power of the positive power o.f touch to heal spiritually, physically, emotionally. Pamela ' s exp erience is very similar, 101 I \V011f th m to know that h aling 1 h a/thy, that emotional pain i really hardfor th m to cop \\'lfh but, thi 1 · this i kind of the flip side omet1ung, of it and I H'ant them to knoH· that , omeone can care about th eir body and mayb the)' cm1, tart to care a l1ttle h1t too . .. it's just part of th e proces , in the therapeutic proce 1·our relationship is eve1ything and {f that 's oing to , trengthen it that that's omg to build that trust. I 've never had sam bodr a. k for a hug and then ne1 ·er come back. or cb rah If a ut "crmnectmf!, 111 a non verbal way, to have that connection because we find a lot o th m g t o lo. t 111 the H'ord. and 1! shuts th em down sometim e ", thu allowmg th r lati n hip t dcvcl p that I cnc . I find you hm ·e to h able to read the k1ds . .. the_v 're not responding to your \\ 'Ord and , ornetirne you ju t. you need to have that touch on th eir body. th ir houlder or their arm or their back just to have that connection ... I think the biggest thing is that I'm here, I'm with you, I'm not judging you. I'm understanding ),·vhat you're going through or !jus - wanted to connect H'ith vou ... sometimes that touch is that little bit of . reality that I'm here and I'm oka_v andfor other people I found that sometim es when I use it it 's just sharing that energy of letting them know that th eirs rnay be depleted by what they're going through but here I am and I'll share some of mine with you as we're here lvorking together. Mary speaks to lived space within the context of her experience not just as a feeling of closeness within the relationship but also in more abstract tem1s to also include space a a break, or a pause, 102 I think I do that (u touch) at lea ton my part I do that to further onnect with that p r on or how th em that th re i th r ... Inoti om kind of connection th ir body a /itt/ bit more or th y 'II hift in th ir eat d[ffi rently wh re, yah, they 'II , h[(t in th eir seat or there's kind of a hifl in th e room, it' kind of like an intermi ion ... ev rybody' so int ns and th n it ames to a commercial and eve1)'body' like kind of 'oh, it' an intermi,, ion' . ... o people kind of. h[(t, get a drink, like have a drink, or Kl en x or H'hatever rhe_v n ed to do and th en get back to it, so it 's kind of I back to the H'ork, so for me, it' kind of like an intermission. Mi hacl and Betty ar in agreement that touch facilitate that en c of clo cnc s "I think th re' that connection in that understanding and care . . . I think rapport building again, connection, team building (Michae l) ", and I gue s I 'm feeling like they need more support than just th e nod or th e eyes, th ey eye contact . . . I think th ey get a stronger connection they fee/like you're really invested m them as a persona and what they're saying . .. I think that 's mainly about the connection and that maybe a sense that! appreciate what th ey're go ing through and we're working togeth er (Betty). Carol speaks to the feeling within the space the counsellor and client arc baring, "that quick touch can be just a reassurance in bringing them back to where the_v need to be in a more calm space". The therapeutic realm is different depending on the pace being utilized. Factor uch as mood or accepted practice within the building and between co-worker clearly influences the experience of th e phenomenon of touch; for example, those with prcvi u 103 w rk p nen e hang their practi e f touch depending n where they arc practicing, "tou h chan d a /itt/ bit wh ni went mor into a counselling role, it's more emo tional touch (Anne)". Mary b ervati n f the hange in the pace within which hew rk i thu I\ worked . .. -.,vhere touch i more oft n u ed and accepted and almost e. p ted . . . if it wa. hown or kind a_[ modeled to me th en I would follow that uit.for that person each p r. on was d[fferent and unique obviously. I p end a lot of tim e j ust kind of watching and thos kind of environment lou h wa de.finiteiJ• not omething that was looked that was used or appropriate. Talking ab ut car c pcricnced through touch , the baring of the experience between coun ellor and client i an attempt to bring the intcri rity to an exteriority. The exi t ntial theme of pace or patiality is not a simple a it may ound . There is the phy ical pace between coun cllor and client, the actual pace of the office, the building in which the office is ituated which would include the waiting area and where the client is greeted, and lastly the relational space, the feeling of clo enes and intimacy between two people. The feeling of being connected, an interiority a well a the act of being connected, an exteriority both speak to how pace shapes an experience thus playing a significant role in the phenomenon. Lived Time (Temporality) Van Manen (2007) tates, " lived time (temporality) i clock time or objective time'' (p. 104). ubj ective time a oppo ed t ubjcctivc time can be c plained imilarly t our perception of time or how time is perce ived . For example, th e c perience of time may be 104 that it pa e fa t r when doing nt, in ntra t t time 1 w ing d w n r pa r whil a mething plea ant r when bu y or ccupied with an ry b red. ung p r ing 1 wer when d in g om ethin g dread ed d time i th temp ral way th e w orld i e peri enced wheth er a n 1 king fl rward t wh t th fu ture ha in tore r a p er n at the end of lifl r 11 ting n pa t e peri cn e . Wh en a yo ung per on graduate fr m hi gh chool, for e ampl n rn a qu ry hi r fa p er r her li fl pl an ; what i th e plan fl r th e rem ainder of th e n ' li fl ? The dim en i n f pa t, pre ent, and future co n titute th e h ri zon n ' li fi w r id . Pa t e peri ence e i t in our mem ori c th at influence th e pre ent, mani fe ting a thing u h a atti tu de, ou tlook, mann eri m and even word u ed in languag . Th p a t i not tat i , however it i ubjcct to th e impac t of th e pre cnt day ituation and it influ ence . Peopl e re-eva luate pa t experiences and how the e expen nee have helped mo ld pre ent percepti on . Thi s re-evaluation can th erefore al o affect perception of w hat th e fu ture m ay bring (va n M anen 2007 ; 2011 ). Within th e counselling rea lm , the confi ne of the coun ell or ' office, how doc touch influence temporali ty? It can reduce ten ion or change how emotive a client i used mainly when the clients are in severe distress when y ou really, really fee l they need th at reas urance or to get calm for the moment, calmed down fro m what they are exp eriencing emotionally so that will e a really, really gentle touch on the hand or a shoulder unless they're really the ones needing and insisting a hug and coming clo e to you right in the severe distres , we wouldn 't, I wouldn 't refu e that {Carol) . B etty a l 0 has experiences where touch influence temporality, while touch i used w ith th e arn e result · th e intention i ' om cwhat different, 105 I have found though i during a e ion I'm very careful if someone i howin a lot of emotion and th ey're tewful and CJying I have learn ed throug h my practic that ifyou touch th em or hand them Kleenex that can st 'P th em from following through and keeping on releasing th eir emotion. o, I'm , I aution my elf with that. But at tim es it feels right to expre that caring to th em. . . o that ' wh n !felt I co uld touch her to give her that connection and under tanding. I wouldn 't have done it while she wa CJying becau e experience has taught me that when you do that th ey quit CJ in right away, and move out of th eir emotion. Wb n a king peopl about life hi tory touch clearly play a rol e in stabli bing the therapeutic relation hip , "It helps build the relationship (Betty)", and tru t within that relation hip. The relationship is solidified because the counsellor is demonstrating an intere t, a caring toward the client th ey can start to recognize that someone can care about, about their healing process, and so then they can start to care about their own healing process ... it 's like they trust me, like it's ... a gift, it's part of the process, it 's part of the real trust bond in the healthy relationship between the counsellor and the p erson who is being helped (Pamela). Past experience of both the counsellor and client influence the decision to utilize touch . According to Anne, Pamela, Cynthia, Susan and Betty these "temporal dimensions of past" (van Manen, 2011) must be considered by the counsellor as part of getting to know the client's personal life hi story prior to considering the present 106 b aus [f th Y 'v p n enc d ome kind of trauma that could really make them o ov r th top ... yo u ju t don't know, you don 't /mow eve1ything that' oing on ·with that p r on ... in term of touch if they've had an p ri n e H'here they've had a e ual a. sault from, omeone I would be ev n mar con r b iou regarding that (Pam ela). and u an, th ir wn r alizati n and awarene over time ha changed or n impa t d wh n a pre 1 u nega ti ve reacti n t t uch ha dictated their approach to t ueh in their pr nt pra tice. I do ha e to knOH' my audience. I do have to know whom I am talking to . I can 't a sume that everyhod_v interprets what I 'm doing in the same way and that H'a H'hen I was working with a group of. . . pecial ed. student and it wa probab(l', it wa ju t another ca e of sort of being, somebody looked a little off and I went to ee how she was doing and I put my hand on her shoulder and she ba ically whipped around and said, 'don't touch me!' (Su an)". What may al o be true is the influence of pre ent experi ence , grea ter awarene s, and ongoing education and how th ese may have changed or influenced their perception or how they view the past "touch was definitely not something that wa looked, that was used or appropriate (in that setting) and a I went through more schooling, I could understand how touch could be interpreted in dffferent ways for the client (Mw:1~ ". Lived time allows for greater development of th e therapeutic relation hip at the beginning of the relationship, because the rapport hasn't been built the same and the connection isn't the same there, but I also hal'(! at the end 107 of a es ion, and it might be my ve1y first es ion with omeone who has laid out a lor of information and it' been a difficult ession, even though th e; don't r ally know me overly w II, or me th em, although I've ju t heard th ir whole tory, I would probably ay to th em, !like to give hugs and if th y would like one I'd be more than happy to. If th ey don't I'd be just as happ about that as well, and some of th em who it's been th eir firs session o oh thank you and th en H'e give a brief hug. It ' like validating that ) ou 're okay, it' okay, you did all that talking and sharing. I'm connecting with ) ou (B tty). How one practice ev lve al o temporal. hanges in attitude, awareness and boundarie occur over time a a coun ellor ' expen ence influ ence hi or her practice. Liv d time i e hibited in the di tincti vene s of each therapeutic relationship and each e swn 1 unique regardl e of the number of ses ions each participant has had with each client, I'm going to say I'm probably thinking about connecting with th e other p erson, showing them the support. I think it's a different way of showing support, touch is, and concern and caring. I mean !think you do that in a lot of ways, nonverbally, by my position in my chair and what I'm doing and my eye contact, my expression on my face, and touch is just another one, and it 's not used all the time. It 's not something that I do with every client, every tim e. I think about one of my last essions it was a ve1y brief touch on th e knee and !think I did it once (Bett;) . 108 an Man n (20 14) u e an e ample of keeping a ecret. hrough ke ping a ecret people 1 am t n g tiate in their interaction with ther what ecret to hare what not ' to hare and t r what purp "ke ping ret e. H w would lived time relate t the oun elling realm of (p. 0 ) or mor relevantly, maintaining confid ntiality? From the lit rature it wa clear that me coun ellor admitted to u ing t uch in their practice while oth r w uld n t. In my reflective journal I noted It i inter ting to note that thi participant spoke about not using touch prior to ace piing th i1n itation to participate in this tudy. Yet in the interview he talks about her us of touch and how she came to th e realization that because of the invitation he started to think about her use of touch, which brought her thought to a more con cious level. Her awarene wa heightened to something she had in fact engaged in previously but on a more instinctual, perhaps unconscious level. In this chapter, van Man en ' (1997, 20 14) lifeworld existential themes of lived relation, lived body, lived pace and lived time were explored, which illustrated the participants' experiences of using non-erotic touch. Through the interpretation of each of the existential themes the true essence of experience has been elucidated. Chapter six re-examines the literature in relation to my research findings, discusse limitations of this study, and examines implications for further practice as well as for service provider organizations . The following chapter will al o discuss considerations and recommendations for counsellor edu ation and furth r re ar h. Finally, chapter six will end with my per onal reflection . 109 hapt r Th purp f thi tudy r ti t u h t dcm n trat and thr ugh t u h , d i i n making and th pr re iew h w th e 1 : Di cu ion and a t e pl r th e arc t y uth. onclu ion p n enc uring thi of coun ell or who u e non- tud y tabli bing and nh an ing relati n hip re re be ing th fi nding aled a cntia l fea ture mmunication about touch and fa ct r influenc ing w ith awarene vcrarching c cnce f thi e p ri nee. f elf, th e cli ent, hi chapter will m pare t the litera ture and di cu ion w ill fo ll ow about th e limitati n of th e tud y, impli ati n fo r furt her prac ti ce and ervice pr vid er rgani za ti n , n id erati n and reco mm end ati on fo r un e llor edu ca ti on, and future r ear h. La tl y, per onal r fl ection wi ll be hared. Re-e amination of th e L iter a ture Thi di cu i n wi ll re-exam ine th e litera ture rev iewed in chapter two con idering th e experi ence of th e partic ipant ' u e of non-eroti c touch to demon trate touch w ith yo uth . A a re ult of the re earch the th eme of communi ca ti on, relationship and deci ionmaking were revealed with awarene a the overall essence of the ir experi ence. C ommunication is one th eme th at the resea rch echoed similarly to the literature review . M any of th e parti cipants reiterated that touch is a fo rm of com muni cation (Aquino & Lee, 2000 ; Durana, 1998 ; Halbrook & Duplechin, 1994 ; We tl and , 20 11 ). ynthia describ ed touch a a "gesture of caring" w hich she atiicu lated i how he show cli ents her care simil arly to Bonitz (2008) who conclud ed the u c of touch upport verba l communicati on with a non-verbal m an . Th i usc of touch i a l o what Gcib ( 1998) describe as a deeper therapeutic experience when language i not enough; it i a new approach to relating, which can be an effective mean to communicate. Toronto 110 (200 1) al le a kn 1 fund r tanding b y nd what w rd can convey. While there i agreement that t u h i a D rm (1 h w t u h compl ement verbal communication a it reache a 5) b li greater en f c mmuni ating n a different plane with one' client , Horton et al. ad p r intimacy i a hieved fr m u ing touch thu contributing to a f afety . When client fee l afe th ey tend t open up m re and therefore, all w for de p e pl rati n f fe ling . Th literature expl re thi c mmunication furth er t in lud h w t u h can help e tabli h an empatheti c connec ti on. rom th e res arch, many parti c ipant p ke of h w a c nnec ti n can happen fr m th e fir t m eeting with client , n t j u t through th e ir poken w rd but al o through b dy langua ge uch a leaning D rward wi th an open body po ture, r through ph y ica l prox imity rath er than thr ugh the u e f t uch. B enefi cial u e of touch i explored a an adj un ct to talk th erapy to enhance th erapeuti c outcom e (Durana, 1998; Fo hagc, 2000; Halbrook & Dupl echin, 1994; Holub & L ee 1990· K ertay & R eviere, 1993; Kupfermann & maldino, 1987; Wil on, 1982). Throughout the literature review elements such as th e enhancement of therapeuti c outcome , touch hav ing a corrective and educati ve benefi t, and the abili ty for touch to heal are highli ghted . While th e parti cipants of my research did not explicitly ta lk about th e u e of touch being of benefi t fo r clients, two poke to the effect of touch with cli ent who show trong em otions. Carol and Betty cited th eir ob ervations of the ir u e of touch with cli ents who are di stressed and crying, which cause th em to stop cry ing. shared her experi ence of using touch with clients who arc high ly di tr arol d and unabl to engage verbally. In th ese in tancc the u c of touch in the moment engage the client to prov ide immedi ate reassurance and allow him or her to return to the present to be in a 111 more ca lm pa e. In ar 1' e peri ence th client eem to relax his or her whole body thu attributing the t uch a helpful to allow the client to hift beyond the di tre m m nt. In thi in tan fe 1b tter. in that the int nt f u ing touch i to allow ome relief for the client to tty' r f1 ction of h r experienc i imilar to Carol' in that the use of t uch with h wi ng a I t f em ti n cau ed the crying to top, di tracting him r her tty m h w. ntinuc to e plain her experience under thi particular cir um tance not nly top the crying, it al o cau e a di connect to the client's strong moti n thu t pping him imil arly b th emotion. r her from fo llowing through and continuing to release the aro l and Betty agree that the client in that in tance must be intervention to help a client hift from fee ling di stres , and Betty as es es whether it is better to u touch and have the client come back to the issue behind the distressing emotion or refra in from touch and allow the client to express emotions in the moment. In both the e circumstances, as Toronto (200 1) points out, one cannot fail to acknowledge that the touch itself is in some circumstances the restorative stratagem; however the awareness around the effect or intent for that touch is varied. ' Primitive. As a result of the literature review three categories were elucidated around touch being primitive. These categories were nurturing touch , attachment, and healthy relationships and nurturance. Harlow 's (1957, 1958) studies with rhesus monkeys , and (as cited by Kupferman & Smaldino, 1987), discovered physical contact between infants and their mothers is crucial for the healthy development of infant . Fo hage (2000) determined touch is a basic behavioural need and when the requirement for nurturing touch remains unfulfilled, abnonnal behaviour will re ult. Both Bonitz (2008) and 112 urana ( 19 infan ) peak t the imp rtan but f touch D r human d vel pment not ju t in a a ult t enj y g i ing and r ceiving phy ica l nurturing in lation hip . H lub and ec (1 90 re ogni ze the ab ence f t uch and it link t infant wh fail t thri c. It i thr ugh the en e f tou h that kin c mmunicate mu h f th in ab ut n elf K rta hil b ing int and th ming me age that arc re p n ib le [! r th e accrual of under tanding R i r , 199 ). It wa ed, "II w dama ging i it when a client need that phy ical touch ar being r j ct d . What me ag d within th intervi w that pr mpted a w ll a a d In t n11 ynthia wh brought up the que tion that g ive?" It i thi lin e of que tioning me th ught about t uch havin g a nurturing effect, I pm ental nccc ity for yo uth . f t uch b ing nurturing, from a parenting per pecti ve F belie e parent t uch of a chi ld goc b yond merely thri v ing; it al hage (2000) create a en e of intimacy , love, afcty, and we ll -being. B etty poke about her touch bei ng a " motherly ge ture. ' he tatcd, " in my belief a mother rc ponds with concern and care . . . o in my experience motherly mean tho e thin gs, attentive, rc ponsivc, in that manner, caring, nurturing. " For B etty, nurturing touch is motherly fro m a caring per pective rather than an overt und er tanding of its affects on development. Explicit and m utual. It i agreed among many re earchers that the use of touch needs to be discussed with clients prior to the initial touching (Durana, 1998; Gcib, 199 Horton et al., 1995; Kertay & R evicre, 1993; We tland, 2011 ). It i not enough to merely talk about tou ch , th e counsell or mu t be clear from the beginning of th th rap uti contract about why touch is or 1 not being included in treatment (We tland, 2011 ), the boundaries of th e therapeutic relation hip (Kcrtay & Revicre, 1993), and to clearly 113 c mmuni at th a t th c li ent ha th e ri ght to c ntrol th e occurrenc of touch ( eib 199 ). T g th r the c un th ra 11 r ' and the cli ent ' per nal tyl e, preference , and exp ectation of mu t be n g ti a t d p Ii icul arl y urr unding th e u c f touch, and mu t be agreed nt (H rt n et al. 199 ). Many of the participant in my up n a part f in[i Imcd n r rba l b dy cue bei ng nc of, if not the main component, in ar h p ke ab u t n d tcrmining hcthcr t u c n n-cr tic t uch wi th a cli ent. Parti cipant were clear that in t in tanc , tou h wa n t th ough t ab ut r ta lked ab ut pri or to the u e of touch for m th fir t tim e. Th c u ld n t be c pl ici t ab ut touch to client when th eir level of f t u h wa m rc fa n intuiti n than mindfuln c . M any addrc cd a proc ba ed n n n-vc rba l bo dy cue and intuition to determin e iftouch wo uld be utili zed . H wever, a ouplc of partici pant ackn ow ledged po t-touch th at th e cli ent did not we l orne th e touch . ne can qu e tion if the di crepancy between the literature and my rc carch is an area where awarene of elf and the cl ient, a we ll a awarene s of eth ics and transparency within th e coun elling rea lm come into play. This incongruity peaks to the need for a vari ety of elem ent to come to light including being fully cogni zant of the benefit of touch to the client a well as the intent to u e touch for the client to fee l under tood, accepted and cared for vcrsu the need of the counse llor to make a client feel better, top crying or beli eve the counsellor is making a difference. For many of the participant , the client 's need or comfort level was dctennined through coun ellor interpretation of client body cu es, whi ch d id backfire for at lea t two participants in at least one incident each . In ta lking about touch with clients not only is the usc of touch di cu ed together; counsell or and client can explore the meaning of the touch a well a both coun llor and 114 client mfi rt le 1 regardmg the u e oft uch. Thr ugh the e type of conver ations the f t u hi ignifi an or mi int rpreting d pl r d (Tor nto, 2001 ). To avoid negati ve response to touch u rea ti n t th h nt ab ut th u f t u h in .. H rt n et al. ( 1 95) tat touch mu t be an authentic 'Pil It r unmi takable ne d [! r phy ical contact. Tran parency en ir nmcnt wh r th 1 11 nt re p nding ba d nth n d n \V uld en ure thi i the ca e thu providing an el he r he 1 in control and the coun cllor is fthe li nt. m parti ipant n t d It 1 quall Imp rtant for coun cllor who are uncomforta ble with th u f t u h t b tran parent with cltcnt in order to eliminate any speculation fr m th nt ham d b hi \\'h t u h rna be withheld, preventing the client from being r h r n d fi r ph ical rca urance or comfort (Horton ct al. , 1995). Pam la tat d h i aware f any kind of tran ference or feelings of a client starting - to b attra t d to h r. nder uch condition he would not use touch because she "can tell" in th way a eli nt look at her that here i transference. When thi is happening within the therap utic realm Pamela stated he put up very clear boundaries with the client. he clarified he would talk with the client about appropriate boundari es in uch an instance. Bonitz' (2 008) work echoes that it is fundamental for counsellors to be aware of any erotic transference or countertransference. Kertay and Reviere ( 1993) add that asking permission to use touch and explaining its intent serves to keep the usc of touch on a conscious level in the therapeutic moment, and of equal importance is the decision to discontinue the use of touch. Geib (1998) clarifies that the limits and boundaric of the touch· · ll ·ts possible sexual aspects must be explored with the mg expen ence, as we as 1 115 client in th th rap utic c un ell r tting. B undary teaching as well as an awarenes of the wn boundari e are crucial. It i important to teach client clear boundaries ith regard t t uch and it i nece ary t hon tly educate client about motive for the u e of coun ellor touch and r lack f touch in different ituation . There were a few parti ipant h pok about maintain ing th ir own bow1dari e when choo ing not to u e tou h, parti ularl y w ith ma le client . K rta and Re i re (19 ) reference Mintz who beli eve coun ellor shou ld never u e touch w ith a cl ient when it i not genuine a doing o may dupli cate previou trauma and in ali date a c li ent' perc ption of what i real. Pamela will not use touch with a cli ent wh en he doe not have expl icit penn i i n becau e he doe not fu lly know a client ' pa t trauma. ynthi a and Deborah wi ll choo e to avoid touch a we ll if the cl ient has a hi tory of trauma to avoid re-traumatization of the cli ent; however, they will not nece arily talk about this with the client nor enquire about hi s or her under tandin g around why touch i not being utilized or his or her need fo r touch. Self-aware. While awareness was the overarch ing theme or essence of my research, I am not certain how self-aware participants are in regards to motivation to use touch or what drives the intuition most participants cited as to how they knew to use touch with cli ents in session. Participants do not discuss the meaning of touch with any clients. Fosshage (2000) however, points out touch can have very different meaning within the dyad depending on who initi ates it. A cl ient's age and gender can also affect the meaning of the touch . It is the responsibility of the counsellor to be aware of the level of signifi cance for each individual client, as the therapeutic proce will be at different stages w ith each client (Kupfermann & Smaldino, 1987). Awarcne s of the meaning of 116 tou h fl r a h client n urc the client doe n t perceive t uch a a boundary violation, m t a utely a e ual ne, au ing great di tre f the m aning f t u h gi fl r a clien t ( eib, 199 ). Being aware ri e t under tanding that even mething a mnocuou a a hand hake ha meaning fl r th e client, and influence the therapeutic proce R 1cr (Kertay & 199 ; T r nto ,2 01). cr tein (2004) a k m e 1mp rtant que ti n that relate to a c un ell or ' u e of non- rotic t uch with a li cnt. " Wh initiated th e hug? Why did y u agree to hug thi p r n? What wa ur und r tanding f th e hu g? What wa th e client' under tandin g of the hu g? H w did the hug further th e relation hip between you and thi s per on?" The e que tion could be a ked ab ut any form of phy ical contact and would crve to h ighten a coun cllor awaren The majority of partic ipant about hi or her motivation for u in g touch in c sion. poke about th e ir awarene of whose need arc being met when utili zing touch, reinforcing that a counsellor mu t be aware that u ing touch is neither unwarranted nor manipulati ve. It mu t be a genuin e re pon c to the client' need for touch (Horton et al., 1995). Fos hage (2000) concur touch mu t be utilized based on the client 's need and in sync with the intimacy of the therapeutic relationship. It i vi ta l for the counsellor to b e clear touch is for th e benefi t of th e client not the coun ell or. As Anne stated and Durana ( 1998) also mentions, a cou nsellor must be very aware of hi or her needs in order to have them met el ewhere. Relation ship . According to Westland (20 11 ), relation hip i the main influence wh n considering whether to engage in phy ical c nta t r n t. Tho c parti ipant wh p k to the deci ion to u e non-erotic touch with a cli ental o a knowledged the imp01iancc of re lationship in correlation with the ability to a e body cue . The mor intimate or 117 de lop d th th rapeutic r lati n hip , the m rc likely a coun llor w uld kn w to u e t u h r n t with ach indi idual lient. Many parti ci1 ant poke to h w the u e of t u h played a rol in e tabli bing and trengthening th e th erapeutic relationship a well. Durana ( 1 ) argu that it i th c un ellor wh mu t be ac ountable for knowing the cli ent w ll enough t determine hi r li ph r her rcadine ~ r phy ica l c ntact. n relati n hip to kn w a cl ient we ll en ugh t a e ical c ntact. u an and A coun ellor hi or her readin c for etty p int out, the th erapeuti c relati on hip is being built from the very fir t c i n and th ere arc cli ent for wh m phy ica l contact i a fundam ental c mp n nt of th e th erapeuti c relati on hip (We tl and , 20 l 1). Durana (1998) caution that it i not ufficie nt fo r the coun cllor to have intim ate know ledge of th eir client coun ell or mu t al o addre ethi cal impli cati on within th e contex t of the therapeuti c relati on hip . Many a pcct within the therapeutic relation hip arc fundamental and must be taken into con ideration such as th e power of the relati on hip . One parti cipant arti cul ated her awarene of thi dynami c and exprcs cd how this influence her decision to touch a client or not. When as essing power di parity within the relationship, one mu t be cognizant of cultural and socia lized difference between cl ient and th erapist (Ho lub & Lee, 1990). Touch can be considered a powerful instrument, which cmpha izc a more open and intimate relationship between client and coun cllor by augmenting the therapeutic partnership as it fac ilita tes a deeper leve l of tru t, which in tum trcngthcn the cmmection between counsellor and client (DUI·ana, 1998). Many participant ' experi ences echo c tab lishing tru t within the therapeutic relation hip with client and 118 trengthening c nn cti n happen as a re ult of u ing touch with client . Through the u e oft uch an empathic connection i form ed, and und r tanding i faci litated thu all owing for thi communication on a d eper level. For example, ynthia exp rienced h r t uch a a ge ture f caring or an ex ten ion of her w rd . Th client feel her care through her touch · the touch i c ngruent with her verbal ex pre ion of care. Limitation of th e tud y Thi tudy like many before, has limitation , which I will acknowledge. Fir tly , being a qualitati ve rc earcher, I a a hum an being am the greatest limitation. Becau e of thi humani tic a pect I had to be awa re of my own personal biase and idio yncrasies to b abl to conduct and analyze the parti cip ant ' interviews to truly eli cit th eir experiences and an wer my research questi on. Ultimately the intervi ews and participant ' responses are only a rich as my ability to stimulate parti cipant conversation and prompt the sharin g of their experiences. Part of this limitation is also being cognizant of my presence while interviewing participants to gather data and to refl ect how being present could affect participant responses. While I have my own interest and experiences regarding the experi ence of using non-erotic touch to demonstrate care as well as established knowledge from doing a lengthy literature review, I had to remain open to hearing about new experi ences regarding this phenomenon to extend my curiosity beyond my own biases, idiosyncrasies and knowledge. Secondly, I invited the participants of this study to share their experi ences, sending them personal invitations. Knowing the parti cipant as colleagues create a dual ro le a colleague and researcher. This tension may have been evident by the freq uent u e of the 119 "y u kn w ' by many parti cipant , thu blurring th e boundarie between fellow phra un ell r and r car her. hirdly th e re ult each parti ipant ch en iti f thi ct tudy arc ba cd on the interpretati n of the experience hare. Therefore, what parti cipant limit the tudy. There arc bared becau e the topi c i me fac tor th at may have hindered baring. The u f n n-cr ti c touch i n t o crtly accepted in practi ce and may even be th ught of a tab m me c un elling en ir nm cnt r pr fe i n . When th ere i th e percepti on or beli ef that n n-cr tic touch t dcm n trate care i inappropri ate or unethi ca l, baring nc' c p riencc ofu ing tou h may be too ri ky, one may fea r be ing j udged orn e parti c ipant commented th at th ey had not thought about th eir experi ence o fu in g touch until I a ked th em to tel l me about th em. The lack of elf-awa renc limited what co uld be bared . It i important to note many of th e participant were un able to describ e th e ir thou ght and fee ling beyond a cnsc of intu ition. Fourthly, th ere wa no cultural atu ration and th erefore no cu ltu ra lly pccifi c observa tion were m ade de p ite there being cultural di versity among t parti c ipant . While the parti c ipant ' p a t experi ences infl uence the ir current experiences, th e majority expressed that their experi ences with client were more dependent on the client a an individual rath er than on any overt cultural norm . Similarly eight of the nine parti cipants were fema le. One lone male voice is insufficient to make pecific gender observati ons or compari sons. Lastly th ere was a heavy re liance on van Man en's tcx t (1997, 2014) to fully comprehend he1111encutic phenomenology. tudying other framework from henn encuti c phenomenologists uch as Heidcgger and Mer! au-Ponty would have further 120 enhanc d the und r tanding of thi methodology and per hap influenced the outcome or furth r upported the outcome. imilarly, not u ing multimodal methods of data colle ti n fl r analy i limited how participant hared their experi nee , thu the data wa not multimodal. Implication for Furth r Pra ctic e Phen menological re earch d e not have as its primary focus the direct application of r ult into practice· howev r, it i worthwhile to e plore implication for further practice, a there ulting de cripti e material may be relevant to many professionals and paraprofe ional . oun 11 r them elve can learn from thi s tudy th e importance of awareness in using non-erotic touch with youth, including awarene s of their own bodily responses to touch, what the touch is communicating, how they communicate with clients about touch, how developed the therapeutic relationship is, as well as the numerous factors that are involved in the decision to utili ze touch. As the research suggests, it is equally important for counsellors to be cognizant of whose needs are being met through touch. Of equal importance for counsellors is to be aware of one's own respon es, reactions and expectations for caring about clients . Being cognizant of one's own history of touch within relationships is crucial in order to address touch within the therapeutic relationship with clients. These discussions would also include the impact of the de ire to express care or share caring feelings within the therapeutic relationship and to be aware of not only the intent but also who e needs are being met. In terms of deci sion making, many participants spoke about being in tunc with clients' body language, yet they could not de cribe what these body cues look like beyond a 121 upl f p cifi c ample when t uch wa not welcome which empha ize th 1mp rtance f awaren Th parti ipant and e pli itly tating the factor influencing one' deci ion. p kc ab ut d i ion making being in the m mentor being omething that i ~ It by th participant and d ne intuitively, yet it eluded de cription. Being pli it ab ut parti ipant were b erving in their client i omcthing participant bared the had n t th ught f befor be in g interviewed and which wa hard to de cribe. D e el ping per nal comfi rt in talking ab ut touch within the coun elling realm with eli nt i a equally imp rtant a talking about variou oth er a pect of the proce of coun elling. Di cu ion would be particularly important for coun ellors who already utili ze touch t allow D r m re tran parcncy within the therapeutic relation hip in order to eliminate any chance of mi interpretation . Through conver ati n with client , the taboo of touch can be eliminated by educating client on hea lthy non- exualizcd touch and the importance of thi type of human-to-human connection. Educating client peak to kill development and being able to afely navigate conversation about topics that may or may not b e comfortable. A thorough understanding of the ethic of touch i of utmo t importance to ensure counsellor action beneficence and non-maleficence . There are many cultural implications fo r practice surroundin g th e importance of being culturally competent and aware . Each individual within a culture or who identifie with a culture is unique and th erefore has his or her own en e of identity wi th culture. ultural awarenes hi ghlights the importance of being open and tran parent with client by a king th em how they navigate touch in their own cu lture, fami ly of origin, and to enquire about th eir views on tou ch and a k about th eir personal comfort level. Taking direction from th e client i , vita l. It i likcwi e ju t a important t di . cu - a lack of touch 122 w ith li nt . r un ell r wh are n t c m[i rtab le wi th touch them elve ' there is a need t b clear with 1i nt that n t t uching them i the typica l practice o client are n t left w nd ring if they arc the only ne n t receiving touch . It w uld be prudent to al addr under what c nditi n ab ut the li nt ' r what circum tancc one may u e touch and enquire mD rt lev I. Impli cation for er vice Provid er Orga nization an rgani za ti n it w uld be va luable t cxpl rc am ng t employee individua l pra tic in rclati n to th e u f non-cr tic t uch . The c convcr ation will al o be imp rati c t ha e durin g up rvi i n, which hi ghli ght the importance of having a up rv1 r who i cry aware of tou ch and th e implication for it u c a well as the efD ct of n t utili zing t uch . A killed superv i or will al o be aware of employee comfort leve l in order to match coun cllor and client ; the intent i to fo tcr healthy therapeutic relation hip and have a good fit for both c li ent and counsellor. Within a service organization all employees would benefit from in -service tra ining to addre 1 sue uch a boundaric , per ona l awarcncs , and how to manage requc t from clients for touch amongst other topic . As arc ult, organi za tion can then con id er agency policy to address the use of touch with consistency and a thorou gh under tanding of touch, how to integrate it into practice sho uld one choose to touch or not, and how to address the counsellor' per onal comfort level about touch with client . It i al o imperative that the environm ent be one where self-care and open communication arc promoted . It would be bcncft ial for all levels of staff to receive training, such a , profess ionals, support taff, and paraprofc sional staff. 123 on ideration and Recomm endation for Coun ellor Education r h m y have impli ati n and fa t r t c n ider £ r c un ell r ducation. hi r Primaril talking ab ut the t p1 r m th tigma and tab f t u h bey nd th e tab about n n- r tic t uch and th e benefit it may have within pc f practi ce . It i thr ugh th at awaren awarene f nv r ati n with pr fe or and fell ow tudent lf will be larifi ed r garding ne' per nal ty le. Through thi f elf ne can come t und r tand hi or her wn co mfort regarding touch and c m t und r tand th benefit t client dem n trat of uneth ical exualized touch ar . f non-eroti c touch when used to qu ally important i di cu ing th e cauti on urroundin g the u e f non- r tic touch and the ethi ca l con iderati on when deciding t utili ze touch or not. oun lling i a caring profe ion and while it i important to rev iew what caring look like it i equ ally nece ary to addre the ham1ful aspect of using touch. Benefi cence and nonmalefi cence mu t be at the forefront of one's decision to utilize touch whil e also con idering fid eli ty and autonomy by taying in tune with th e need of ind iv idu al client . Of considerati on regarding the use of no n-erotic touch i educati on around how to touch within the afe confine of the therapeu ti c relationship, which would include knowing its importance, limitati ons, and benefi t beyond wha t one feel intuitively. Educating client abou t the use of safe touch would include comprehending when not to touch as we ll as practice in addre sing the deci ion to uti lize touch or not with cli ents. Consid era tio ns an d R ecomm end atio ns for Future Research Looking beyond what the research ha ugge ted, it would be ad vantageou to re earch and Jearn how to utili ze tou ch in a corrective manner in rder t teac h cl ient for 124 wh m a~ n n- e ualized touch i probl matic that touch doe not mean lov nor i it a precur r ~ r ual relation hip . It could be worthwhi le to examine the u e of non- er ti tou h a a meth d within th afe confine of a therapeutic relationship to teach a client b r wh m t uch ha only been e uali zed about the touch . cial more of non- exualized ne would n ed t full y expl re how u ing touch for teaching purpo e would happen while keeping the cli ent and oth er who are in contact with the client safe. Touch pro id a c nnecti n b yond what can be portrayed through word . Touch i about feeling n t ju t th n ati on of fee ling the touch f two peopl e coming together, but it is al o ab ut fee ling m oti on u uch a care, belonging safety and security . How does the of touch impact attachm ent, healthy relati on hip and healin g? econdly, future re earch mi ght examine more in depth th e experi ences of male coun ellor . There are some ocietal view and a sumpti ons about males using touch with female cli ent as well as with boys. It would be advantageous to explore th e beli efs of male coun ellors fu rth er to more fully understand bow gender impac ts the decision to utilize non-erotic touch or not. Of equal interest would be to fu rther explore th e experiences of female counsellors and any hes itancy to u e non-eroti c touch with male cli ents. Many of the parti cipants reported not using touch w ith male cli ents yet none of the research I read indicated that males di d not benefit from non-erotic touch. Betty pondered why she would choose to touch a female client when a ma le cli ent may receive equal benefit from similar types of non-erotic touch. Con tinuing with the theme of gender differences and similarities , it would be advantageous to question whether touch affects males and fe males differently and is there a need to que tion the difference of 125 g nd er n ed within th e c un elling realm a well a comfort and de ire for non-er tic t u h. Thirdl D 11 w ing thi mpari a a tudy I am curi u ab ut the experi ence of demon trating care n betw en children y uth and adult . Much of th e re earch I read w a adult ba ed onl briefl y di cu ing th u e of t uch w ith children r youth , whi ch al o ugg t th n ed D r mor yo uth ba ed re earch on the topic f n n-eroti c touch . A a re ult f my re arch, a c upl e of parti c ipant poke about th e u e of touch w ith children be ing m r direc t d t ward k eping th m afe r c mforted ver u a caring ty pe of tou h th ey wou ld u e w ith you th. In expla inin g th e di fference the parti cipant de cribed th e dec i ion ba ed on the develop mental level f th e child or youth . I am curi ou to kn w m re about th e d ifference ba ed on age of the cli ent a we ll as th e power differenti al w ith in th e relatio n hi p between cl ient and coun ell or. I wond er if the relati on hip w ith an adult versu th e re lation hip w ith a child or youth has a di fferent level of power from th e coun ellor ' per pective. It wo uld be intere ting to co mpare how the age of th e cli ent in flu ence a coun ell or's experi ence. orne participant spoke to the environmen t in which th ey worked and how work place influen ced their decision to u e non-ero ti c touch as well a their own per onal comfort. It would be interes ting to understand how the environment influences the u e of touch and how it affects th e service that client receive. Pursuing thi . re ear-ch from the clients' perspecti ve would be noteworthy . M any participant admitted to not overly ta lking about or thinking about their u, e of touch unti l they received an invitation to participate in thi study. nee engaged in th interview process, there were component to the u e of non-erotic touch that had not 126 b en p l red r th ught ab ut until they engaged in conver ati n regarding their p n nee . n idering the ariety of educati na l background que ti n if thi ha an in flu nee n the fi rce me to pau e and lf-reflecti n c mponent of practice. Patiicipant wh c mpleted ma ter degree admit t being more elf-aware and elf-reflective b cau e f th ir ducati nal e perience wherea other reporied the u e oft uch imply being intuiti n r intuiti with ut the reflecti n f elf. I did not read any re earch on th impa t f th I cl of c un ell r ducati n n th e importance of elf-reflection, elf- r full under tandin g ne' m tivati n t u en n-erotic t uch in practice or awar ne an awarene f tran paren y in the cou n clling proce urrounding the u e of touch in c un eling. one of the participant have doctoral degree yet the majority of the re earch I read wa from the p r pecti ve of therapi t at the doctoral level. Taking into con ideration the awarcne of variou factor that affect the experience of u ing non- erotic touch to demon trate care, in the future one may wish to pur ue the question of how one' level of education influences his or her awareness within the com1 elling realm particularly when utilizing touch to demonstrate care? La tly, a couple of participants poke about and questioned the effect of not providing touch to a client who may need it. What would be the effect of not providing touch to a client who needs it and what is the level of detriment for withholding touch? Al o, what i the effect of providing non-genuine touch on both cli ent and coun ell or? Future research might examine this from the per pective of both coun ellors and client . Personal Reflections Throughout the proce s of conceptualizing this thesis re earch, developing the propo al, executing the research and now writing my finding , 1 have much to reflect on 127 I liken thi pr and e t that f aring fi r a b n ai tree, a l w pati ent proee hittling th plant to the hape I envi ion . The pro e wai ted .G r the tree t h w ign of cutting wa at time daunting a I f gr wth yet al o an iety prov king a a myriad of th ught and unan w red qu tion pre nt d them lve to me about how thi tiny plant w uld gr w t what I wanted itt lo k like when the pnmin g wa c mp lete. I found that th m re attenti n I paid t it th ea ier it wa tom nitor the gr wth, althou gh there were da wh n taring at it wa futile. The day of procra tination and avoiding caring for the plant t k on a life f it wn and I had t revi it and reimagine what I thought it hould I ok like nee my attenti n returned to the plant. I had to a k my elf innumerable time , i thi what I really want to be doing? What am I doin g thi for? I had made a c mmitment t my elf, one that wa far more involving th an I knew, to keep thi plant alive and to nurture it the be t I could with the tool I have. At times I had to rei gn in my hope a well a my dreams bccau e I had troubl e stru gglin g with wanting it to be perfect. De pite wanting it to look perfect, it wasn't go ing to get that way without takin g a tep back to make ob ervation about the overall hape it wa takin g on, being ca refu l to ee all part of the plant, to elici t input from others about th e direction th ey aw it growing in, and knowing when tori k snipping off whole branche to get the de ired outcome and avoid the effects of overgrowth. As various stages of the tree grew and were haped to form my ideal, I noticed reluctance within my elf to finish with that portion . I as ociate it to cutting off a large portion of growth knowing it will en hance the overall hapc and health of the tree I'm envisioning, yet hesitating to do so for fear other may judge me for the shape it is taking on, that omehow it might be wrong or other may not hare in my vision or understand what direction I want the tree to grow in. I have pain taking! 128 learned how t care t r thi bonsai tree and talked my elf into and out of variou change in hape. I hav allowed my parti ipant to direct it temptati n to pa hape while not giving in to the the tree on to omeone el e r to compo tit. I have an abundance of gratitude for my parti ipant in their wi llingne to open ly hare their experience , re ulting in the hape the tree to k; without their involvement I would not have a tree to care for. 129 References Aquino A., & Lee . (2000) . Th u of nonerotic t uch with children: thical and dev 1 pmcntal c n ideration . Journal of Psychoth erapy in Independent Practice, 1(3), 17-3 0. d i: l0 .1300/J2 8v0ln0 3 02 B ciati n of linical un ell r . (2009). ode of ethical conduct: tandards of clinical prac ti ce and guideline for regi tered clini cal counsellors. Retri eved from www. bc-coun llor .org/general/code-of-ethical-conduct-and- tandards-oflini cal-practi ce Bonitz V. (2 00 ). e of physica l touch in th e "talking cure": A journey to the outskirt of p ychotherapy. Psychoth erapy, Theory, Research, Practice, Tra ining 45(3), 39 1-404 . doi: 10.103 7/aOO 133 11 Braun, V ., & larke, V. (2 006). U ing themati c analysis in p ycbology. Qualitative R esearch in Psychology, 3(2), 77- 101 . doi:10.11 91/1478088706qp063oa Bums, N. (198 9). Standards fo r qualitati ve research. Nursing Science Quarterly, 2(44), 44- 52. doi : 10.11 77/089431848900200 112 Caelli, K ., Ray, L. , & Mill, J. (2003). 'Clear as mud ': Toward greater clarity in generic qualitative research. International Journa l of Qualitative Method , 2(2), 1- 13. Calmes, S.A., Piazza, N .J., & Laux, J.M. (2013). The use of touch in com1s lling: An ethical decision-making model. Counselling and Values, 58, 59-68. doi: 10.1002/j .2 161-007X.20 13.00025.x Canadian C un elling and Psychotherapy Association. (2007). Code of ethics . Retri eved from http ://www.ccpa-accp.ca/_ documcnts/CodcofEth ics_ en_ new.pdf 130 anadian P ychological ociation. (2000). anadian code of ethics for psychologists. Retrie ed from http ://www.cpa .ca/cpa it /u erfiles/Document I anadian%20 de%20o£U/o20 thic %2 0for%2 0P ycho .pdf oll ege f P ycho logi t f Briti h lumbia. (2 009). Code of conduct. Retrieved from http ://www.c llcgeofpsychologi ts. bc.ca/doc 11 0. PB odeofc onduct2009 .pdf re w 11, J. W . (2007). Qualitative In quiry & Re earch Design Chao ing Among Five Approa he (2nd d.). Thou and ak , A: age Publi cati on . de Witt, L . & Ploeg J. (2 006) . ritica l appraisal of ri gour in interpretive phenomenologica l nur ing research. Me th odological Issues in Nurs ing Research, 55(2). doi: 10. 1111 /j .1365-2648.2006.03898 .x Du rana C. (1998). The use of touch in p ychotherapy: Ethical and clini cal guidelines. P ychotherap; , 35(2) , 269-280. do i: 10. 108011064026049052 1479 Finlay, L . (2012) . U nfo lding the phenomenological research process: Iterative stages of "seeing afresh" . Journa l of Humanistic Psychology 53(2), 172-20 1. doi : 10.11 77/00221678 12453877 Finlay, L. (2 01 4). Engaging phenomenological analysis. Qualitative Research in Psychology, 11 (2) , 12 1-141. doi :10.1080/14780887.2013 .807899 Fossage, J. L ., (2000). The meaning of touch in psychoanalysis: A time for rcasscs mcnt. Psychoanalytic Inquiry, 20(1), 21-43. doi:10 .1080/07351692009348873 Geib, p ., (1 998). The experience of nonerotic physical contact in traditional psychotherapy. In E . W. Smith, P. R. Clance, & S. Imes (Eds.), Touch in psychoth erapy the my, research, and practice (pp . 109- 126). N cw York: Th Guilford Press. 131 . (2004) . T hug r n t t hug . Eating Di ord r , 12, 61-365 . d i:10.10 0/ 10 402604905 2 1479 Halbr upl chin, R . (1 94). Rethinking t uch in p y h therapy : ~ r pra titi ner . P ) choth Harri , K . ( 19 5). uideline rap; in Private Practice, 1 ( ) 4 -53 . llectcd qu t fr m !bert in tein . Retrieved from http :// mp . tanford .c du/~ he hire/ in tcin u te .html H th rin gt n, A . ( 1 9 ). The u e and abu e f t u h in therapy and coun elling. oun e ffing P )'Cholo Quart rly, 11 (4 ), 361-364. d i:10.10 0/09515079 0 254067 Holub . & Lee, . ( 1990) . Thera pi t ' u c of nonerotic phy ical contact: ""' thical cone m . Profe ional P ychology: Re earch and Practice, 21(2), 1 15 - 117. doi : 10.103 7/0735 -7 028.21.2. 115 Horton , J. , C lance, P ., terk-E lif on, C., & mshoff, J. (1995) . Touch in p ychothcrapy : A urvey of pati ent 'experience . P ychoth erapy, 32(3), 443-457. Hunter, M ., & Struve J. (1998). The dynamics of touch when applied in p ychotherapy. Th e Ethical Use of Touch in Ps; choth erapy (pp. 111-1 35). Thou and Oak , A: Sage Publications. Kertay , L ., & Reviere, S. (1993). The usc of touch in psychoth erapy: Theoretical and ethical considerations. P ychotherapy, 30( 1), 32-40. doi : 10.103 7/003 3-3204 .30.1.32 Kupfennann , K , & Smaldino, . (1987) . The vitalizing and the revita li zing c pcncncc of reliability: The place of touch in psychotherapy. Clinical ocial Work Journal, 15(3), 223-235. 132 a rty, .M . (200 ). Herm neutic phenomenal gy and phen menol gy: compan f hi t ri al and m th d 1 gi al c n ideration . International Journal of Qualitativ Meth od , 2( ) 2 1- 5. Ma a ngcl u . (20 14, ember). The i graphy .c m web tie . Retri eved from http ://www.biography.c m/peop le/may-angelou-91 53 Mayan M.J . (200 ). E entials of Qualitative Inquiry. Walnut reek, A : eft oa t Pre Me ei l-Haber, F.M. (2004). thical con iderati n in the u e of nonero ti c tou ch in p ycho th erapy with chi ldren. Ethics & Behavior, 14(2) , 123- 140. M rrow .L. (2005). Quality and tru tworthine in qualitative re earch in co un eling p ycho logy. Journal of ounsehng Psychology, 52(2), 250-260. doi : 10.103 7/0022-0167 .52.2.25 0 Phelan, J. (2009). xp loring th e u e of touch in th e p ychotherapeuti c setting: A phenomenolog ical review . P ychoth erapy: Th eory, Re earc·h, Practice, Training, 46(1), 97-111. doi :10.1037/a0014751 mith , J.A. , Flower , P ., Larkin, M . (2009). Interpretative Phenomenological Analysi Th eory, Method and Research. Thousand Oak , A: Sage Publi cation . Stenzel, C., & Rup ert, P . (2004). Psychologists' u se of touch in individual psychotherapy . P ychoth erapy: Theory, Research, Practice, Training, 41(3), 332-345. doi : 10.103 7/00 33-3204.4 1.3 .332 Tan, H ., Wil on, A., Olver, I. (2009). Ri coeur 's th eory of interpretation : n in trument for data interpretation in henn eneuti c phen meno logy . International Journal ol Qualitative Methods, 8(4), J- 15. n 133 Tor nto , .L . (200 1). Th e human t u han xploration of th e rol e and meaning of phy ieal t u h in p ychoan aly i . Psychoanaly tic P ychology, 18(1 ), 3 7-54. Van Manen M . (1 997) . Fr m m aning to m ethod . Qualitative Health Re earch, 7(3), 45-469 . Van M anen, M . (1997) . R earching lived experience human science for an action en itive p edagogy. L nd on, N : The A!thou e Pre s. Van M anen, M . (2006) . Writing qua litatively, r th e demand of writing. Qualitative Health Research, 16(5) , 71 -722 . doi: 10.11 7711 0497323 0628691 1 Van M an en M . (2007) . Phenomenology of practi ce. Phenomenology & Practice, 1(1 ), 11 -3 0. Van M anen M . (201 1). Ph enomeno logy online a re ource fo r phenomenological inquiry . Retri eved from http ://www.ph enomenologyonline.com/inquiry/ Van M anen, M . (2014) . Phenomenology ofpractice meaning-giving methods in p henomenolog ical research and writing. Walnut Creek, CA: Left Coast Press. W estland, G . (2011 ). Phys ical touch in psychotherapy: Why are we not touchin g more? Body, Movement and Dance in Psychotherapy, 6(1), 17-29. doi : 10.1080117432979.201 0.508597 Wilson, J.M . (1982) . The value of touch in psychotherapy. American Journal of Orthopsychiatry , 52(1 ), 65 -72. Y ardley, L. (2000). Dilemmas in quali tati ve health research. Psychology and Health, 15, 2 15-228 . 134 Appendix A perience of Demon trating B are to Youth U ing Non-Erotic Touch 1.E d . Th e i Rc earch by ancy n low-Tooke Ma t r of ducation - oun elling pecialization tud ent Re earch Participant Information Letter and Con ent Form What i th e Purp o of th e tud ? Th purp f thi h 1pin g pr Ii i n w h car t eli nt . Th de e min d. How W er e You to under tand th li ved c pcricn cc f tho c working in a t engage in n n-cr ti tou h a a mean to demon tratc utilize thi technique to demon tratc car wi ll al be ho en to P a rti cipa te in thi a pra titi n r w rkin g in tud y? helping profc ion, you arc being invited to participate. What am I A kin g You to Do? PI a e read thi information Jetter carefu lly. If you arc willin g to hare your experience of d mon trating care through the u c of non-erotic touch in an interview, and to ha c the interview audi otapcd, you can contact me, Mrs. ancy An low-Tooke by email at an lowt@,unbc.ca or by phone at 250-730-286 (cell ) to let me know that yo u will be willing to participate. We wi ll arrange a time and pl ace for you r interview that i convenient for you. The interview wi ll take approximately one hour. When you arc interviewed I will record your tory in order for me to tran crib and review it for analy i . After I have reviewed the transcription , and the analy is i comp lete, I wi ll a k you to review th e analy i for accuracy. Thi wil l involve a second hort interview of approximately thirty minute . You will be able to add any infonnati on and let the re earcher know if the analy is is correct. Who Will Have Access to Yo ur Data ? No one except me, Nancy An low-Tooke, will have accc to the information from your interview with yo ur name attached. My univcr ity profcs or, Dr. Linda 0' eill may have accc to your anonymou informati n to help me with my analy. i . I wi ll be record ing and transcribing yo ur interview my. elf, and th ere wi ll be no one eL e vvho read , your information. Participation in this tud y is Voluntary You may decline my invitati n to parti ipate in thi s research study by simp! tgnonng thi wri tten invitation. Jf yo u choose to parti ipatc, you may wtthdrm\ ftom the stud at 135 an tim · If Y u in the tudy. ithdraw n n f the in:D nnation that y u contributed will be includ d Potential Ri k and Ben fit Ther ar p t ntial m tional ocial and legal ri k involved in participating in thi mfl rtable _:D r y u to talk ab ut y ur e perience of demon trating tud . It rna ar thr ugh th u f n n-er t1 t uch . h uld you e perience any emotional or p ch l gical di tre , I wil~ pro ide y u with a li t of community re urces, which you can a ce . au f the 1ze of the community, it i pos ible that your employer could b com aware f ur participati n in thi tudy . I will uphold the limits of nfidentiality f any p r nal in lvement or informati n di cl sed within the context f th r ar herr lati n hip unl yo u ha ve given con ent to di clo e your information t Y ur mpl r. h uld y u di clo e harm t a child , or the intent of anyone to harm a hild it i my legal and ethical re pon ibility to report it. lllimitation of confidentiality will b uph ld . My h p i that y ur participation in thi tudy will benefit u both. You may feel validated in ur d ci i n to utili ze non-erotic touch in your practice. You may feel ati fied in knowing that you ar co ntributing to a research tudy . Your participation in thi r arch tudy will benefi t me a a coun elling rna ter tudent who want to und r tand th e e p ri ence of using n n-erotic touch in practi ce. Anon ymity and onfid enti ality Your anonymity will be protected to the best of my ability, a only l will have acce to the information in your interview with your name attached. However, due to the ize of the community in which you live, there is a risk that you may be identified and therefore anonymity cannot be guaran teed . You or I will choose a p eudonym to identify you in my the i - individual names will not be used in any future presentations , report , or journal article . Confidentiality is important to me because I will learn the mo t from your open responses. B ecause your responses will be kept confidenti al, they will not po e any risk to your reputation. I recognize that it is difficult to as ure anonymity in smaller communi tie . I will work with you to ensure that no information presented in th e final thesis or presentations can be linked to you. My supervisor is an expert in sma ll community research and will provide support in this task . Information Storage All information from this research will be stored in a locked filing cabinet at my personal residence and on my password-protected computer. All electronic data will be erased frmn the hard drive and related paper documents will be shredded two years after publication. The only remaining material after thi time will be my c~m~ I ete~ tl~esis, presentation and/or papers that relate to the research but do not contam 1dent1fymg information. 136 Que tion or Concern about this Re earch If you ha e que tion about thi re arch , plea e contact m r y u may contact my Ma t r upcr i r r. Linda ' eill by em ail at lon e ii J@ unbc .ca or by phone at 2509 0-6414 . If y u ha e c ncem or c mplaint , y u ar encoura ged to contac t th e UNB ffi c of R c earch by m ail at reb@unbc.ca or by phon e at 250-960-67 35. Re earch R e ult a h parti cipant w ill b given ummari e of th e th emati c analy i at the econd interv iew t check for accura cy . Verb atim tran cripti on of the initial intervi ews wi ll be available t parti c ipant up on r qu e t. The c mpletcd re arch w ill be pre ented at my th e i defense at UNB . It i anticipated th at th e re ult w ill be pre ented at confe rence , and publi bed in professional journal or rep rt . Y ou m ay obtain a copy of the re earch result by contactin g th e re earcher ancy n low-T o ke by em ail at an lowt@unb c.ca or by phon e at 25 0-73 02 6 (cell) r r. L ind a ' eill at I nei1l@un bc .ca. Research Qu e tions The fo llow ing que ti on w ill guide th ere ea rch: • What i the exp eri ence of usin g non-eroti c touch to demonstrate care in profes ional helpi ng practi ce w ith youth? • What fac tor influ ence your deci ion to engage in non-eroti c touc h or not? 137 pp endi B : R e earch Participant Con ent Form Ye No re earch Do you under tand that writt n form ? Do you know what co mmunity re ourcc arc available for additional ort? rovide? Thi tudy was explained to me by: Printed name of Research Participant: I agree to participate in this research study as described in the Infon11ation Letter. I am agreeing an audiotaped interview of approxima tely one hour in length with que tion about my experience with u ing non-erotic touch to demonstrate care with youth. Signature of Research Parti cipant Date 138 App endix C : Community Re ources Li t ounselling and upport erv ices: lberni ommuni ty and W omen ' crv icc o iety Be Ro oun lling and on ulting ommunity un clling and n ultin g crv1ce ri i Inform a ti n L ine ri i Line - moti nal upp 1i Toll Fre n 1 rv icc (K ) r road oun cllin g roup Port Alb n1i Famil y uidance A oc iati on rca Healing oluti on Deborah W ei June raham Dea Par ani hi 25 0-724-7 111 25 0-724-2522 25 0-723-9392 800-5 8-87 17 25 0-723-40 50 888-494-3888 800-588-87 ] 7 25 0-720-0316 25 0-724-01 25 778-42 1-0672 2 50-7 3 1-8 144 25 0-723-9777 25 0-735-0942