A qualitative content analysis of ChatGPT's client simulation role-play for practising counselling skills

Role-play is often used as a pedagogical technique by counsellor educators to help counsellors-in-training (CITs) learn and practise counselling skills. This study used qualitative content analysis to assess the effectiveness of Chat Generative Pre-Trained Transformer (ChatGPT), an artificial intelligence (AI) chatbot, in simulating client role-play to facilitate practising counselling skills. The author used 10 case vignettes to conduct a simulated role-play where ChatGPT was asked to simulate the client and author as counsellor. The results indicated that ChatGPT demonstrated authenticity, consistency, appropriate emotional expression, cultural sensitivity, empathy and self-awareness while portraying the client. However, at times, ChatGPT's responses to the counsellor's questions appeared overly idealised, lacking the authenticity typically observed in real clients. Furthermore, ChatGPT, as a simulated client, lacked non-verbal cues, limiting the overall experience of counselling skill practice. Recommendations for CITs and future research are discussed.     

The relationship between counsellor interpersonal skills and the core conditions of client-centred counselling

The present study aimed to determine whether there was a systematic relationship between Rogers'(1957) core conditions of empathy, acceptance and genuineness, and counsellors' use of specific behaviours or skills which have been isolated for training. Video recordings of 12 counsellors' performance in 'naturalistic' counselling interactions were analysed. Counsellor, client and judges' ratings of the core conditions were obtained. Skill assessment included molar ratings of eight skill areas and molecular measures of 29 behaviours. The results indicated that there were few significant relationships. It is concluded that there is a discrepancy between specification of the skills or behaviours which are thought to communicate the core conditions and those which have been empirically demonstrated to do so. Implications for counsellor training and proposals for future research are discussed.     

Personalized versus standard role plays in the assessment of depressed patients' social skill

Chronically depressed outpatients participated in a study of the role-play assessment of social skill. Patients role-played a series of standard situations typical of those employed in social-skills research and additional scenes drawn from critical situations in their personal lives. These “personalized” role-play situations were perceived as more relevant by patients and resulted in more discomfort and less skillful interpersonal behavior than standard scenes. Behavioral measures derived from personalized role plays were also found to be more strongly related to measures of depression than the same measures derived from the standard role-play scenes. Implications of these findings for the role-play assessment of social skill are discussed.     

Client perspectives on counselling: Before,during and after

This four‐year study investigated the under‐researched area of first‐time users’ perceptions of counselling and how these evolved over time. Research participants were drawn from six settings within university counselling services, the voluntary sector and primary care. Using an interpretive hermeneutic framework based on thematic analysis, 30 interviews were carried out. Results revealed that before counselling, participants were uncertain about the nature of counselling and what to expect, described stigma associated with peer influence and varying levels of confusion about specialist language. During counselling, participants experienced some level of positive change. At the same time, divergences of counsellor and client perception highlighted theoretical issues concerning counsellor approach and the exploration of emotions. Post‐counselling interviews revealed further positive change, and practical issues with implications for counsellor training and practice in terms of client assessment, preparation for counselling and the influence of cultural assumptions on theory and practice.     

Empathic interactional sequences and counsellor trainee effectiveness

Consecutive counsellor trainee and client statements from 12 audiotaped assessment interviews were coded to operationalize empathy as a sequential variable. For each two statement sequence the speaking order (counsellor to client, client to counsellor) was also coded, and the resultant matrix analyzed via loglinear statistical procedures for categorical data. For the speaking order client to counsellor, three empathy sequences (empathy enhancing, empathy diverging, empathy commencing) were found to be significantly related to counselling effectiveness. For the speaking order counsellor to client, only one sequence(empathy diverging) was found to be significantly related to counselling effectiveness. Implications for counsellor training and future research are discussed.     

Encouraging counsellor reflection

The evolution of an 'attributes checklist' tool for assisting counsellor development is described. The attributes relate to characteristics of case-notes that indicate evidence of counsellor reflection and consideration of the counselling process. The checklist was initially tested among a sample of 19 counsellors employed by an organisational EAP and was subsequently refined. The final checklist tool was found to be both usable and useful in differentiating 'process' from 'content' notes. The purpose of the checklist tool is not to enable quantitative assessment of counsellor notes, but rather to facilitate counsellor development within a professional supervisory relationship. The findings of the study are discussed, and suggestions for future research in this area are made.     

What makes a good counsellor? An analysis of ways in which counsellor trainers construe good and bad counselling trainees

As part of an investigation into criteria used by counsellor trainers to distinguish between good and bad students of counselling, experienced counsellor trainers were asked to complete a repertory grid. Each trainer was asked to list five good counsellor trainees and five not so good or bad counselling trainees they had worked with, as elements for the grid. Repertory grid forms were provided by the researcher with spaces for ten constructs which were elicited from the trainers in the standard triadic manner. For each elicited construct subjects were asked to rate each trainee on a five point scale. Twenty-seven correctly completed grids were collected. The 262 constructs elicited were conflated into 22 semantically similar categories by the researcher and independent raters. The data was subjected to statistical analysis using the Statistical Package for the Social Services (SPSS). Overall the constructs that were most frequently used in describing trainees were open-closed, personable/aloof, secure-insecure, professionally skilled-unskilled. The mean differences for scores of good and bad trainees for each of the 22 conflated constructs were calculated. The greatest mean difference related to professional competence. The 22 conflated constructs were subsumed into three categories, and the mean of the difference between ratings for good and bad trainees within each category was calculated. Counselling related competence showed the greatest mean difference. Implications for counselling course curricula and the selection and assessment of counsellor trainees are discussed.     

Factors affecting the social validity of a role-play test of children's social skills

The social validity of a role-play test of children's social skills, the Social Skills Test for Children (SST-C), was evaluated by 63 subjects (33 adults and 30 children) who subjectively judged the quality of three children's role-play performances. The three children were selected as having high, medium, or low social skill based upon their performance on the SST-C. Assessment of the effects of subject characteristics upon judgments of social skill suggested that similarities in age and race between the subjects and the three children tended to diminish perceived differences in social skill among the three children. It was concluded that the social validity of the role-play test was supported only if the persons evaluating social behavior were dissimilar in age and racial characteristics from the persons who were being evaluated.     

A study of Muslim Asian women's experiences of counselling and the necessity for a racially similar counsellor

A survey of four Muslim Asian women of varying ages was carried out, for whom the author had previously acted as a counsellor. The survey was designed to explore the extent to which client and counsellor racial similarity affected the therapeutic alliance, as the counsellor/author was of a similar race to all four clients. It was the author's belief that racial similarity in itself would not procure positive counselling outcomes, and hence this study attempted to explore the clients' perceptions of qualities extrinsic to race, including interpersonal skills, styles and approach to counselling of the counsellor, in order to duduce whether in fact these factors were more singnificant to the outcomes than race. The majority of clients did not feel racial similarity was an essential quality, although one client expressed cultural awareness as being a preferable quality. This has suggested that it is not essential for client and counsellor to be racially similar in order to achieve successul counselling outcomes.     

Specialist counsellors in primary care: The experience and preferences of general practitioners

This paper reports the results of a postal questionnaire, pre-coded by practice, which was sent to all 484 Leicestershire general practitioners. Practitioners who could and who could not refer to an in-house counsellor were compared in terms of their views about counselling provision, both within the practice and by agencies outside, such as mental health teams and specialist counselling services. General practitioners having access to a counsellor belonged to practices which were larger and had fundholding status. No signijicant dafference was found between rural and urban practices in their employment of an in-house counsellor, although those doctors working in rural areas were less likely to see this service as having a high priority. General practitioners without in-house counsellors estimated a referral rate (for counselling) in excess of twice that of the actual rate reported by those with practice counsellors. Those having an in-house counsellor were more likely to agree with statements that emphasized the benefits of this form of provision as against that offered by either mental health teams or specialist counselling services.     

Consistency of supervisor and peer ratings of assessment interviews conducted by psychology trainees

Observation of counsellor skills through a one-way mirror, video or audio recording followed by supervisors and peers feedback is common in counsellor training. The nature and extent of agreement between supervisor–peer dyads are unclear. Using a standard scale, supervisors and peers rated 32 interviews by psychology trainees observed through a one-way mirror. Results indicated that peers and supervisors used similar dimensions to cluster the various competencies. Peers rated counsellor performance more positively for general counselling skills, but not for specialised techniques. Analyses revealed good supervisor–peer agreement for some items and poor agreement on others, with some differences being unacceptably large. The study has important implications for how feedback involving supervisors and peers might be managed and for peer supervision models.     

Evaluation of a microskills programme with field-based counsellors: Effects on core attitudes and counselling skills

Two issues relevant to the role of microtraining in counsellor training are examined. Firstly, due to the increasing use of the microcounselling framework for training counsellors, either directly or indirectly, in the Rogerian attitudes, the effects of such a programme on counsellor attitudes was investigated. Secondly, although microskills training has been generally found to improve and increase trainee's helping skills usage and effectiveness, its effects on field-based counsellors have rarely been evalulated. Thus the second objective of the study was to examine this issue. The subjects were 12 counsellors from a number of counselling agencies. Six of these counsellors participated in a microcounselling programme which taught the skills of nonverbal communication, questioning, reflecting, listening, self-disclosure, reinforcement, opening and closing. The data base for the study consisted of videorecordings of each subject's participation in two extended interactions—one involving an individual discussing a real concern, and the other involving an individual discussing a simulated concern. Various measures of counsellor attitudes, effectiveness, skills, and actual behaviours were obtained. Comparison of the experimental and control groups indicated that the microcounselling programme had little effect on any of the aspects of counsellor performance examined. It is concluded that, although aspects of the design may have influenced the results, an integrated microcounselling approach may be more effective in developing attitudes. In addition, it appears that the characteristics of a professional population, such as counsellors, may differ from those of novices, such that problems in effecting change in skilled performance will occur with the former group.     

The context of counselling: A neglected dimension of trainings research and practice

The context of counselling includes such factors as the physical environment of the counselling room, the emotional climate of the counselling agency, the relationship between the agency and the community it serves, and the cultural beliefs and values which inform both counsellor and client. It is argued that these factors can make a difference to the relationship between counsellor and client, and the process and outcome of counselling. It is suggested that contextual issues have been largely ignored in counselling theory, research and practice, and that increased attention to context has the potential to contribute to the creation of more responsive and effective counselling services.     

Counselling students' views and concerns about weeping with clients: A pilot study

This study examines counselling students' concerns and views about a phenomenon that has received little attention in the counselling literature: the counsellor weeping during a session with a client. Over 20 per cent of the counselling students who were surveyed reported being concerned about weeping in session with clients. However, the majority of students believed, to varying degrees, that weeping with clients could facilitate the therapeutic process. This paper sheds light on this unexplored dimension of countertransference, and has implications for those involved in providing counsellor training.     

When does counsellor forward lean influence client-perceived rapport?

Data from nine one-hour counselling interviews with a standardised client were examined for the relationship between counsellor forward lean and client-perceived rapport. Results indicated that more extreme forward lean (i.e. of 41 degrees or more) was significantly more common during minutes rated as 'very high' in rapport. By contrast, less acute forward lean was significantly less frequent during such high-rapport minutes. Plots of forward lean over each minute of the counselling interviews revealed some further variations in usage of forward lean, with suggestings for counsellor training and practice.     

Genograms in counselling practice: A review (Part 1)

Genograms are an important clinical tool for many counsellor, therapists and other health care professionals and can be used for assessment, gathering information on family relationships and exploring themes in counselling practice. This article reviews the recent literature on genograms and examines the efficacy and use of this tool from a number of perspectives including the use of genograms in health care, psychological counselling and in genetic counselling. The predictive value, and future development of the use of the genogram in counselling are also discussed.     

'If you don't want to tell anyone else you can tell her': young people's views on school counselling

The aim of the research was to assess the views of young people about school counselling. In total, 415 pupils from five secondary schools took part in the survey. A smaller number of these pupils took part in focus groups (n=9) to explore their views in more depth. In general, the young people seemed to value having a school counsellor. Most were aware of the school counselling service, although a substantial number (21%) indicated a lack of awareness. For many who were aware, their knowledge of the service was limited. Just over one third of the pupils stated that they would go to see the school counsellor, and girls were more likely to state this than boys. The confidentiality of the service was perceived to be one of the benefits. However, this was also reported to be a hindering factor—the concern that it may not, in fact, be confidential. Two other main reasons for not accessing the service were the counsellor being a stranger and (for boys in particular) a concern about other people finding out (associated with the social stigma of going for counselling). Suggestions to improve the school counselling service included a room in a discrete location, better promotion of the service, more counsellors or a full-time counsellor, and ways to get to know the counsellor better. Those responsible for developing and managing school counselling services should consider these suggestions.     

Psychometric characteristics of role-play assessments of social skill in schizophrenia

There is an extensive literature documenting that people with schizophrenia have marked impairments in social role functioning and social skill. One of the most widely employed strategies for assessing social skill has been role-play tests: simulated social interactions that are videotaped for subsequent behavioral coding. There has been considerable discussion of the validity of the approach in the literature, but there has not been adequate consideration of other psychometric characteristics of role-play tests. This paper examines the psychometric characteristics of a representative role-play measure: the Maryland Assessment of Social Competence (MASC). Data from 5 large schizophrenia studies that included the MASC were examined: a study of victimization in women who abuse drugs, a study of health care among people with diabetes, a study of vocational outcomes, a study of social skill among drug abusers, and a clinical trial comparing two antipsychotic medications. Data were examined in terms of five questions: (1) Can role-play scenes be rated reliably? (2) How are role-play ratings distributed across populations? (3) How many and which behaviors should be rated? (4) How many role-play scenes are required? (5) Is role-play behavior temporally stable? Overall, the data suggest that the MASC, and by implication other similar role-play procedures, does have good psychometric properties. However, several things often taken for granted in the literature warrant careful consideration in the design of research using role-play. Implications of the results for design of research are discussed.     

Client or patient? Contrasts between medical and counselling models of confidentiality

Conflicts can arise within counseling in primary care settings over issues of client confidentiality as perceived from a therapeutic as opposed to medical perspective. ‘Ideal types’ of counseling confidentiality and medical confidentiality are compared, according to a proposed structural model of confidentiality. In contrast with a therapeutic concept of confidentiality as an interpersonal contract between client and counsellor, a structural model of confidentiality appropriate to medical and primary care settings would include reference to crucial aspects such as risk assessment, and the sharing of client information within a multi-disciplinary team. The client-centred counselling model of confidentiality is then explored with reference to the Derbyshire Inquiry Report on the mental health care provided for a client with psychiatric problems. The limitations of adopting an exclusive client-centred counselling approach towards confidentiality in primary care settings are noted, given the requirements of the Care Programme Approach for effective risk assessment and inter-professional liaison in the care of client and patients with psychiatric problems. The potential resultant issues of counsellor and general practitioner liability are identified in relation to complaints systems and the key legal concept of vicarious liability.     

An Evaluation of the Effectiveness of Self-Efficacy as a Predictor of Trainees' Counselling Skills Performance

The value of self-efficacy as a predictor of counselling skills performance in a graduate counselling class was evaluated with 31 trainee counsellors. Three measurements of self-efficacy were taken: before, midway through, and at the end of a microcounselling skills training programme which was taught over six weekly three-hour sessions. Although there was a wide distribution of self-efficacy reports, none of the estimates of grade were significantly positively associated with counselling skills. Implications for counsellor educators are discussed.