Training Counsellors to Work with People who Live with Cancer: A Needs-led Approach to Planning

This paper traces the development of a cancer counselling service within a voluntary helping agency. The steps of recognizing the needs of people with cancer, identifying multi-faceted desired outcomes and the implementation of one specific goal, that of provision of a counselling service, are outlined. Significant events, stages and decisions made during this process are described and discussed. The emphasis throughout is on the importance of needs analysis and client group consultation in order that the planned service is best placed to meet such needs.     

The role of educational counsellors in Kuwaiti secondary schools

Previous studies of educational counselling in Kuwaiti secondary schools have identified several concerns including inadequate facilities, a lack of clear role definition, and possible difficulties arising from the attempt to combine Western counselling models with Islamic values. To obtain information about the current state of educational counselling all 32 educational counsellors from Kuwait's credit course secondary schools were interviewed and were asked to complete checklists and time‐scale questionnaires. Analysis of the results suggest that development of the service has been uneven, and that role ambiguity, inadequate training and poor accommodation remain problematic. Recommendations for the remediation of these problems are made.     

Beyond resolution of presenting issues: Clients' experiences of an in‐house police counselling service

The availability of counselling services for employees has expanded significantly in recent years. However, despite an increase in appreciation of the value of counselling within the police service, there has been little research into the effectiveness of counselling with police personnel. The present study assesses an in‐house counselling service provided by the welfare and counselling department of a Scottish police force. Thirteen former clients (including both police officers and civilian support staff) were interviewed about their views on four areas of the counselling provision: how they entered counselling, the issues they brought, their experiences during counselling, and their assessment of the impact of counselling on their lives. Interviews were analysed using a grounded theory approach, which identified four main categories: initial engagement, learning by participating, experiencing moments of deep self‐examination, and moving beyond resolution of presenting problems. All of those who were interviewed appreciated the provision of a counselling service within their employment, and the majority reported that they had not only been helped to resolve their presenting problems, but had also made important gains in self‐awareness and work effectiveness. Findings are discussed in terms of implications for service delivery and future research.     

A survey of student counselling in higher and further education in the United Kingdom

All higher and further education institutions who reported having a student counselling service were surveyed, using a postal questionnaire, during 1985. Information from 212 institutions is presented. It describes what services exist, how long they have existed, their staffing and their workload (in terms of numbers counselled and type of service offered). Comparisons between universities, polytechnics and colleges of higher and further education are made. The stated objectives of the counselling services are summarised, together with identified priorities in counselling functions. Some of the characteristics of counsellors are outlined, including hours worked, training and qualifications.     

Telephone counselling for adolescent suicide prevention: changes in suicidality and mental state from beginning to end of a counselling session

Telephone counselling is an accessible and confidential means by which distressed young people can seek help. Telephone counselling services were funded under Australia's National Youth Suicide Prevention Strategy between 1997 and 2000. In this study, the effectiveness of telephone counselling for young people seeking help in the context of suicidal ideation or intent was evaluated in an investigation of calls made by suicidal young people to a telephone counselling service. Independent raters measured callers' suicidality and mental state at the beginning and end of 100 taped counselling sessions. Changes in suicidality and mental state were measured using a reliable rating scale developed for the study. Significant decreases in suicidality and significant improvement in mental state were found to occur during the course of counselling sessions, suggesting positive immediate impact. Limitations of the study with respect to longer-term outcomes and the relevance of the results for suicide prevention are discussed. Notwithstanding the study limitations, the results lend support for continuing development of hotline services.     

Research on embedded counselling: An emerging topic of potential importance for the future of counselling psychology

A significant proportion of the counselling that people receive takes place within informal, situated encounters between service users and practitioners in fields such as nursing, medicine, teaching and social work. However, almost all of the research that has been carried out into the process and outcomes of counselling consists of studies of formal, contracted counselling and psychotherapy based in therapy clinics and offices. The competent and effective delivery of counselling that is embedded in a primary professional role, such as that of nurse, teacher or social worker, presents considerable challenges for practitioners. Research evidence around the process and outcomes of embedded counselling represents a valuable resource that has the potential to enhance the quality of counselling conversations enacted by practitioners in health, education, social work and other professions. An overview is provided of different types of research that has been carried out into informal and embedded counselling, and of the main themes that have emerged from these studies. Suggestions are made for the further development of this field.     

Statistics and economics of educational counselling in one university

An attempt is made to evaluate the cost-effectiveness of educational counselling, based on a study of a sample of 603 students attending counselling sessions in the University of Birmingham. The difficulties of finding criteria to judge the efficacy of counselling, and of controlling for other influences, are discussed. The analysis shows that 56% of the students who came for help to the educational counselling service (mostly as an 'end-of-the-road' referral, or through self-referral) have subsequently obtained degree qualifications. The current cost of 'rescuing' one student is estimated as being in the region of 29.     

Coping with childhood cancer: The case for long-term counselling help for patients and their families

A case is made for a skilled, independent counselling service to be made available to children with cancer, and their families. Evidence is presented from a selected review of recent literature, and the stated needs and views of a small group of parents obtained by counsellors' in-depth interviews. This evidence shows the stresses imposed, and the inability of the medical team fully to address these needs concurrently with treating the illness. Skilled, long-term counselling for patient and family is seen to be an important aspect of a comprehensive childhood cancer service.     

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.     

Challenges to addressing student mental health in embedded counselling services: a survey of UK higher and further education institutions

With reports continually demonstrating increased demand and severity of student mental health needs, it is important to gain a fuller understanding of the impact on embedded student counselling services. The aims of this research were to identify (a) service similarities, (b) factors which impact on services, (c) characteristics of service users, and (d) the use of therapeutic technology (e.g. online self-help). An online survey was completed by 113 heads of UK student counselling services across Higher Education (HE), Further Education (FE), and Sixth Form Colleges (SFCs), to capture service data from the academic year 2013/14. Students predominantly received high-intensity support (e.g. counselling) and referrals increased over 3 years. Challenges to embedded counselling services and their implications for development are discussed.     

Counselling in primary care and the new NHS

A detailed overview of the changes in the structures of the new NHS in England, Scotland and Wales is presented, looking at the effect these changes will have on counsellors working in primary care. New structures for the provision of counselling in primary care and their implementation are explored. Supervision of counsellors in primary care is addressed and how supervision might fit into a managed counselling service. The requirements of clinical governance are discussed, as is the necessity of appropriate audit and evaluation data to inform service and individual development.     

A naturalistic longitudinal evaluation of counselling in primary care

This study evaluated the effectiveness of generic counselling in a primary healthcare setting during three months of counselling and followed up the patients' progress after counselling had finished for the next twenty-one months. Questionnaires were completed by patients within the Dorset Primary Care counselling service on referral to counselling and at set points afterwards. A naturally occurring waiting-list group was compared with patients receiving counselling at baseline and three months. Measurements were taken of patients' psychiatric symptomatology, quality of life (QOL) and self-esteem. Patients who received counselling made highly significant improvements compared with those on the waiting list. These improvements were maintained throughout the long-term follow-up. This would indicate that generic counselling has positive effects that can be maintained for a long period of time after counselling has been completed.     

Relateline: An evaluation of a telephone helpline counselling service for marital problems

A year's entries in the log-book of a Relate (Marriage Guidance) Helpline telephone service were examined and analysed. The data recorded there enabled the researchers to collect and evaluate information about the callers, their problems and the responses made by the counsellors. The aims of the service were to offer a prompt response to people whose relationships were in difficulty and were unable to wait for a face-to-face appointment, and to relieve the pressure on the normal counselling service. An assessment of the value of the telephone service is made in the light of these aims. Some of the results are presented and discussed.     

Psychoanalytic psychotherapy and student counselling

This paper explores the experience of a psychotherapist working in a university counselling service, indicating the contribution I think a psychoanalytic orientation can make to this kind of work. The exposed ‘coal face’ nature of the work is illustrated, and some of the psychotherapeutic implications of working within a large organisation discussed. There is an exploration of institutional dynamics which bear directly upon the psychotherapist, in terms of what it is possible to provide, and of professional self-preservation and self-esteem. Analysis of the uses made of the counselling service is seen as a contribution towards enabling the service to represent properly itself and its concerns within the institution.     

Cancer counselling in the United Kingdom

Abstract

A national survey of 289 people from a variety of professions (nurses, social workers, clinical psychologists, psychiatrists, etc) involved in counselling cancer patients and their families within the United Kingdom obtained a response rate of 82%. The primary findings discussed in this paper cover a range of issues, including the working conditions and responsibilities of the counsellors, what professional qualifications they possess, the extent and availability of supervision and support, as well as the types of counselling intervention employed. Particularly disturbing was the fact that only 25% of our sample had any recognised formal counselling qualification and that 75% did not belong to any professional counselling organisation. In view of the wide diversity of qualifications, salary scales, responsibilities and working conditions and practices amongst the respondents, we propose that the National Health Service (NHS) should establish clearer guidelines as to the minimum acceptable qualifications for people employed as oncology counsellors, and that more adequate provision and resources are made available for training and supervision.     

Cognitive counselling intervention: treatment effectiveness in an Italian university centre

Offering counselling to students is increasingly considered as a key academic service. However, the reduction of resources allocated to Italian universities emphasises the need to assess the quality of interventions. This paper presents data reporting the effectiveness of a university counselling service. A sample of 45 undergraduate students completed a cognitive-relational intervention at a counselling service in a University in the North of Italy. The project focused on the development of reappraisal skills and problem-solving strategies to manage difficult situations. The results showed a significant pre and post-intervention reduction in self-reported psychopathological symptoms (measured with Symptoms Check List 90-Revised) as well as in general levels of distress (measured with Clinical Outcome in Routine Evaluation-Outcome Measure). A significant increase in reappraisal levels, measured with the Emotion Regulation Questionnaire, was observed, which is a focal element of the counselling intervention. There were no detectable changes in the level of suppression.     

Counselling psychology in primary health care: A review

This paper reviews the development of counselling psychology within the field of primary health care. Issues discussed include liaison between counselling psychologists and other professionals, evaluation of treatment in primary care, family therapy in general practice and general practitioners’ skills in counselling. The need for training and evaluation of counselling are discussed and suggestions are made for further research.     

Applied pluralism in the evaluation of employee counselling

The method and major findings of a complex, 'pluralist' evaluation, which investigated the effectiveness of the counselling provision of an employee support and counselling service in a local authority education department over 22 months, are outlined. Reference is made to the underlying philosophical approach of integrated pluralist evaluation, which may represent a significant step forward from the accepted methods of triangulation. In addition to achieving predicted high satisfaction rates from clients, counsellors and clients both indicated significant improvements in all measures used. These were maintained at follow-up which took place at intervals from 1 to 18 months after counselling had ended. Reduction in absenteeism post-counselling suggested the possibility of very substantial revenue savings. Responses also indicated the acute, and often chronic, need for employee counselling provision in the education system.     

An outcome evaluation study of a psycho‐educational course in a primary care setting

Rationale: To date relatively little research has examined the effectiveness of psycho‐educational courses provided in a primary care setting to adults with mild‐to‐moderate mental health concerns. Aims: To determine whether group psycho‐education could be a viable alternative to individual counselling by (1) assessing the clinical effectiveness of an 8‐week psycho‐educational course, and (2) examining the group outcomes in comparison with individual treatment outcomes from a previous study in the same counselling service. Method: A total of 57 participants attending a psycho‐educational course provided data over a 36‐month period, using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) pre‐ and post‐intervention. A comparison was then made with the data of 58 previous participants of individual counselling evaluation, using the same CORE‐OM system. Results: Participants reported significantly lower levels of psychological distress after attending the course and these results are comparable to outcomes measured in the same service for individual counselling, indicating that group interventions could be considered a legitimate alternative to individual counselling, thus increasing cost effectiveness and reducing waiting times. Limitations of the study and implications for practice and further investigation are considered.     

Stress counselling in the Post Office

This paper highlights a unique experiment in stress counselling in industry. It will provide the background to an in-house stress counselling service for postal employees in the north-west and north-east of England. The structure of the counselling service, its location within the organization, the problems of setting it up, the terms of reference, the client base and many more issues will be discussed. In addition, systematic evaluation of the effectiveness of the service has also been independently undertaken and will be discussed. Preliminary findings on the impact of stress counselling on sickness absence and psychosocial measures of job stress are presented and discussed.