A systematic review of the literature on counselling and psychotherapy for the prevention of suicide: 1. Quantitative outcome and process studies

Scope of review: The paper reports a meta‐review of 15 previous systematic reviews and meta‐analyses of the literature concerning the outcome of counselling and psychotherapy with people at risk of suicide; a meta‐analysis of 67 outcome studies in this area; and a narrative review of 17 studies of the therapeutic process. Publication time span: The literature reviewed was published between 1981 and 2008. Publication origin: The majority of the literature reviewed was by authors from the USA or the UK, but there were also authors from other European countries, Australia, Canada, India, and Sri Lanka. Findings: There is evidence of the effectiveness of dialectical behaviour therapy, cognitive‐behavioural therapy, and problem solving therapy, but also for other forms of therapy. Therapist and client variables, as well as the therapeutic relationship, appear to be related to treatment outcome. Conclusions: People at risk of suicide should have access to psychological interventions, including, but not necessarily limited to, those within the cognitive‐behavioural spectrum. Therapies for which there have been promising findings, but which are under‐researched, should be a research priority.     

A journey through languages: A systematic literature review on the multilingual experience in counselling and psychotherapy with children and adolescents

The purpose of this research was to address the gap in the existing literature on the multilingual aspect of language in psychotherapy with children and adolescents. This research aimed at interpreting possible meanings for clients of being multilingual in the therapeutic process as well as reflect on the influence of clients’ multilingualism in the therapeutic relationship. The researcher used a systematic literature review (PRISMA guidelines, 2009) to select articles based on empirical qualitative/mixed studies with participants up to 25 years old or adults referring to childhood/adolescence. The researcher used thematic synthesis (Thomas & Harden, 2008) to extract, analyse and interpret data. The rigour of this study was enhanced by the use of auto-ethnography as a source of evidence (McLeod, 2015). The auto-etnography documents self-reflections on personal experience of being multilingual contributing to deeper contextualised knowledge. The findings confirm previous research on the existence of a link between multilingualism and “identity” (Costa, 2020, p. 5). This research suggests that the meaning a client gives to bilingualism can be co-constructed within an attuned therapeutic relationship. In this co-construction journey, there is a significant opportunity for children and young people in finding their way through languages, hence reaching emancipation and affirmation in the world. The main limitation of this research relates to the fact that there are not many studies with children/young people. This led the researcher to also include studies based on a mixed sample and with adults referring to childhood/adolescence, which might have influenced the interpretation of findings.     

An integrative review of the person-centred and experiential therapy literature on delivering individual video counselling and psychotherapy

Based on an integrative review of the relevant literature in and on person-centred and experiential (PCE) therapy, this study identifies and discusses the findings of 13 articles on the delivery of individual video counselling and psychotherapy. Six overarching themes were identified: the discrepancy of the experiences of clients and practitioners; the possibility of good-quality PCE therapy (psychotherapy and/or counselling); “doing” PCE therapy online; “being” online; the role of technology; and implications for training and practice. It is suggested that all these have implications for ongoing practice and education/training, and need to be considered by practitioners, educators/trainers, and professional bodies.     

Considering methodological integrity in counselling and psychotherapy research

Within the field of counselling and psychotherapy research, qualitative methods have been a longstanding tradition of inquiry due to the mutual interest of therapists and researchers in both internal experiences and intersubjective processes. Methodological integrity is a conceptual framework that has been advanced to increase the rigor of these methods. In this paper, we consider the value of this concept for counselling and psychotherapy researchers and reviewers. This framework guides investigators and reviewers to consider how procedures can be adapted to meet the goals of specific studies, given their characteristics and approach to inquiry. In this brief article, we exemplify the relevance and application of this concept to this field by describing the decision‐making process within the designing of a qualitative research project to investigate clients' needs within rape crisis counselling. Through this exemplar, we also provide guidance to counselling and psychotherapy researchers on considerations during the process of research review and reporting.     

The effectiveness of counselling with older people: Results of a systematic review

In 2003 the British Association for Counselling and Psychotherapy (BACP) commissioned a systematic review of the research evidence relating to counselling older people. This paper reports on some of the findings of this review, particularly those which address the effectiveness of counselling with this population. Electronic searches of the research literature spanned six databases and were supplemented by hand‐searches of reference lists and key journals, along with an extensive search of the “grey” literature. The location of papers testing interventions which fall within a definition of counselling set out by the BACP, with samples aged 50 years of age or above resulted in the inclusion of 47 relevant studies. Studies investigated a variety of mental health problems in older people, particularly depression, anxiety, dementia and the psychological impact of physical conditions such as chronic obstructive pulmonary disease. Of the 47 studies, eight tested counselling as a generic treatment, 15 tested cognitive behavioural therapy, 13 tested reminiscence therapy, and 11 tested various other specific approaches. The review concluded that counselling is efficacious with older people, particularly in the treatment of anxiety and depression and outcomes are consistent with those found in younger populations. Evidence as to the efficacy of counselling interventions in the treatment of dementia is weak.     

Facilitating the client's experience of relational depth in counselling and psychotherapy: A thematic review

Aim

There is increasing interest in relational depth and its relevance and benefits for clients receiving therapy in a number of different therapeutic orientations. This research set out to draw together the available evidence from a wide range of therapies about clients' experiences of relational depth. The aim was to identify approaches that create the conditions where relational depth is more likely to be facilitated. The research focused on clients' views, given the increasing emphasis on their experiences in therapy.

Methodology

A systematic search of papers published in English between January 1996 and September 2022 was conducted using EBSCO Host, Google Scholar and citation chaining. Twenty-seven papers met the inclusion criteria, and a thematic analysis was conducted on these papers.

Findings

Six themes were identified: (1) establishing dialogue with the client's inner world, (2) working with attachment in therapy, (3) responding sensitively to the client's beliefs and values, (4) deepening the client's understanding of the therapist, (5) addressing ruptures in therapy and (6) the client's role in meeting at relational depth.

Conclusion

Facilitating the client's experience of relational depth can support and enhance many aspects of therapeutic practice and in itself may contribute to healing. Therapists who offer warmth and genuine engagement are more able to build confidence and trust, as long as these conditions are received by their clients. It is the clients who ultimately decide whether or not to share their deepest feelings.     

Introduction to the Special Section ‘Innovative counselling and psychotherapy research methods’: Defining the future of counselling and psychotherapy research

In the call for papers for this Special Issue, we sought submissions that would introduce innovative methods with the potential to shape counselling and psychotherapy research into the future. We believe that we accomplished this goal and that this issue introduces a range of valuable examples of current innovations in counselling and psychotherapy research methods. Through the review process, we encouraged authors to offer practical guidelines on how to innovatively assess and analyse change and other relevant aspects of therapy. We also guided authors to not only provide the field with an update on cutting‐edge methodology, but also describe these methods in a practice‐friendly way. As such, the Special Issue aims at becoming a building block for future practice‐friendly research in counselling and psychotherapy.     

Understanding the context of suicide in master's level counselling programmes in Australia

The purpose of this study was to understand the context of suicide in master's level counselling courses in Australia. The sample comprised courses accredited by the Australian Counselling Association (ACA) and the Psychotherapy and Counselling Federation of Australia (PACFA). A mixed methods content analysis was used to identify the explicitness of suicide in these courses and identify themes that emerged during the analysis. The sample consisted of 405 units of study contained in 26 courses. Suicide was explicit in 23 units in 17 courses. Suicide content was overshadowed by cultural diversity, ethics, morality and philosophy, research and self-awareness, which was explicit in all 26 courses.     

The effectiveness of workplace counselling: A systematic review

Background: In response to the stresses of the contemporary workplace, the challenges of maintaining satisfactory work-life balance, and the costs to business of employee mental health problems, many organisations have contracted to make counselling services available to their staff. It is essential to evaluate the effectiveness of workplace counselling, in order to maintain standards, and to identify examples of good practice. Objectives: This paper presents a comprehensive, systematic review of the effectiveness of workplace counselling. Findings are analysed in terms of client satisfaction, psychological functioning, the meaning of work, work behaviour, and negative outcomes. Findings: Taken as a whole, the results of research suggest that counselling is generally effective in alleviating psychological problems, has a significant impact on sickness absence, and has a moderate effect on attitudes to work. Discussion: Methodological issues are discussed, and it is recommended that more high-quality research is required in order to reinforce the evidence base for workplace counselling in relation to a number of key questions.     

Cultural landscapes in counselling and psychotherapy: Introduction to the Theme Section

The concept of ‘culture’ is gaining in significance within the discourse of counselling and psychotherapy, as a means of making sense of the ways in which shared identities and behaviours are constructed and maintained. The selection of papers included within this Theme Section explore different aspects of the use of the idea of culture within counselling and psychotherapy. In this introductory piece, we seek to place this work in a social and professional context.     

Counselling in primary care: a systematic review of the evidence

Primary objective: To undertake a systematic review which aimed to locate, appraise and synthesise evidence to obtain a reliable overview of the clinical effectiveness, cost‐effectiveness and user perspectives regarding counselling in primary care. Main results: Evidence from 26 studies was presented as a narrative synthesis and demonstrated that counselling is effective in the short term, is as effective as CBT with typical heterogeneous primary care populations and more effective than routine primary care for the treatment of non‐specific generic psychological problems, anxiety and depression. Counselling may reduce levels of referrals to psychiatric services, but does not appear to reduce medication, the number of GP consultations or overall costs. Patients are highly satisfied with the counselling they have received in primary care and prefer counselling to medication for depression. Conclusions and implications for future research: This review demonstrates the value of counselling as a valid choice for primary care patients and as a broadly effective therapeutic intervention for a wide range of generic psychological conditions presenting in the primary care setting. More rigorous clinical and cost‐effectiveness trials are needed together with surveys of more typical users of primary care services.     

Universities are not a good place for psychotherapy and counselling training

This paper outlines eight aspects of institutional practice in university teaching that are at odds with the ethos of therapy: the linearity of university training has consequences for conceptual and cultural issues that may be antithetical to genuine therapeutic practice; certain notions about what reality is and what counts as truth may be reinforced by university trainings; academic knowledge in universities is standardized so as to sabotage therapeutic work; the university privileges a cognitive account; the university trains therapists in ways that are antithetical to the ethos of therapy; universities keep alive hierarchies that sit uneasily with the project of therapy; university training encourages the therapist to develop an identity that is anathema to many traditions in therapy; and compartmentalization of ethics in university-based trainings would run against the ethics of therapy.     

Interpersonal psychotherapy: A review and multicultural critique

Interpersonal psychotherapy (IPT) is a therapeutic approach focusing on the role of interpersonal dynamics in creating psychological difficulties that may be particularly relevant to the field of counselling psychology. IPT’s development within randomized controlled trials in the 1970s resulted in a strong empirical foundation without a cohesive theory. Regardless, theorists have since created a theoretical framework for IPT, which has received empirical support. Counselling psychologists have contributed to this research base and may have unique expertise to enhance IPT. Specifically, counselling psychologists can help integrate multicultural and diversity perspectives into IPT with the goal of creating a more culturally competent approach. For example, several aspects of IPT can be expanded to reflect these perspectives, such as integrating cultural sensitivity, cultural knowledge, cultural empathy, and cultural guidance. The authors conclude that IPT is a well-researched and effective treatment approach that holds potential for continued development within counselling psychology.     

The counselling and psychotherapy profession in Canada: regulatory processes and current status

ABSTRACT

Like the Canadian landscape and culture, the status of professional regulation for counselling and psychotherapy is a mosaic reflecting the unique cultural, linguistic and contextual realities of Canada. Statutory regulation in Canada is constitutionally a provincial/territorial matter. In the past five years, a major movement towards professional regulation has emerged. The authors describe the variable status of regulation, focusing on three provinces: Quebec, Nova Scotia and Ontario. They explore the federal Agreement of Internal Trade, designed to facilitate inter-provincial/territorial mobility of regulated professionals. Finally, the authors summarise national research and development activities of the Canadian Counselling and Psychotherapy Association that enhance the pan-Canadian mobility of practitioners and support shared professional understandings. These activities range from bilingual, national validation of competencies, definitions, titles and scopes of practice to symposia and an entry-to-practice competency assessment.     

A systematic literature review on the association between loneliness and coping strategies

Loneliness is an emerging and important public health concern associated with increased risk for health disorders and even mortality. Interventions targeting coping strategies might be effective in alleviating feelings of loneliness. However, the relationship between loneliness and coping strategies is not well understood. We systematically reviewed quantitative studies addressing the association between loneliness and coping. Studies were included if loneliness and coping styles were measured with a validated scale and the association between both was assessed quantitatively. We searched Medline, Embase, PsycINFO, Cochrane Library, and CINAHL databases in compliance with the predefined in- and exclusion criteria. Two independent reviewers performed the search, quality appraisal, and data extraction. Coping styles were subdivided according to problem-focused and emotion-focused coping strategies. We included twelve studies that measured the association between loneliness and coping. Half of the studies had low risk of bias (n = 6), in the remaining six the risk of bias was moderate (n = 1) or high (n = 5). All studies that showed a significant association between loneliness and coping consistently showed that problem-focused coping styles were associated with lower levels of loneliness, and emotion-focused coping styles with higher levels of loneliness. Our findings suggest that learning how to use problem-focused coping strategies could be an important aspect of interventions targeting loneliness. This should be further explored in randomized clinical trials. Trials should report changes is coping and changes in loneliness and also include multivariate models that investigate if changes in coping contributed to changes in loneliness. Furthermore, further research should explore the role of different subgroups (e.g. older people), and the role of different types of loneliness as these can affect the effectiveness of loneliness interventions.     

Matrices in black and white: Implications of cultural multiplicity for research in counselling and psychotherapy

There is a lack of resarch into the relationship between culture and ethnicity, and the processes and outcomes of counselling and psychotherapy. This paper explores current and historical approaches to defining ethnicity and cultural identity, and makes suggestions for how these constructs might be more usefully understood.     

Reliability and validity of an auditing tool for person-centred psychotherapy and counselling for young people: The PCEPS-YP

The present study aimed to test the reliability and validity of the Person Centred and Experiential Psychotherapy Scale–Young Person version (PCEPS-YP). This is a newly developed and adapted 9-item scale which aims to measure counsellor competences in, and adherence to, person-centred practice, when working with adolescents. Counselling practice was assessed for 19 counsellors by randomly selecting 20-min audio segments from 142 recorded counselling sessions. Audio material was independently rated by eight raters using the PCEPS-YP to produce an average adherence rating per counsellor. Scale reliability was assessed via interrater reliability and internal consistency testing. Convergent validity was tested using ratings from the observer-rated Barrett-Leonard Relationship Inventory (BLRI Obs 40), and the scale was subjected to exploratory factor analysis. Results showed a high degree of internal consistency within raters (α = 0.95), marginally acceptable reliability across grouped raters (α = 0.58) and weaker reliability between pairs of raters (α = 0.50). Exploratory factor analysis revealed one strong factor for the scale with no subscales. Small-to-moderate correlations existed between the PCEPS-YP and the BLRI subscales and mean total score (rs = .12 to .40). Our findings suggest that the PCEPS-YP has potential as an effective, reliable and valid tool for assessing competence and adherence in person-centred practice with young people, both for research and for clinical purposes. However, training procedures need to be established that can enhance interrater reliability, and more evidence of convergent validity is needed.     

Towards a model of self-awareness development for counselling and psychotherapy training

Self-awareness has been considered to be a critical ingredient for effective counselling and psychotherapy. However, training models have failed to provide an integrated and explicit approach to self-awareness development. The authors therefore introduce and describe the integrated model of self-awareness development and discuss potential applications for counselling and psychotherapy training.     

解释现象学分析在中国的运用：系统评价及指南

作为一种质性研究方法, 解释现象学分析在心理学及社会科学的其他领域中逐渐兴起。目前在中国, 运用解释现象学分析的研究质量参差不齐, 对这些研究进行系统评价, 可以为将来的研究提供指导。通过对中英文数据库的检索及筛选, 最终纳入49篇期刊文章。根据Smith (2011)为解释现象学分析提出的4个标准对这些文章进行评价, 结果显示, 26篇研究明确提及了解释现象学的理论原则, 33篇文章的资料收集及分析过程清晰透明, 大部分研究(n = 40)条理清晰、言之成理, 但只有约1/4的研究(n = 13)提供了足够强的证据来支持其提取出来的主题。只有4篇全部达到质量标准, 11篇基本达到标准, 大部分文章没有达到标准。最后, 本研究尝试提出一份解释现象学分析的使用指南, 供将来的研究参考。