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.     

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.     

Online counselling: The experience of counsellors providing synchronous single‐session counselling to young people

Kids Help Line (KHL) is a national Australian youth counselling service that provides free online and telephone counselling. This qualitative study examines the experience of 26 online KHL counsellors. Using a focus group methodology, counsellor responses were organised into categories: privacy and an emotionally safe environment; communication through text; and time. Counsellors reported the main benefit of the online environment to be emotional safety, due to reduced client emotional proximity to the counsellor, and the main disadvantage to be that reduced emotional proximity and the absence of non‐verbal cues could result in communication problems and difficulty in accurately assessing young people's concerns. Time proved a significant issue for counsellors, as the slow speed of text exchange could limit their ability to complete interventions. Methods that enhance both the process and effectiveness of online counselling are needed. Potential solutions to the challenges faced by online counsellors are discussed.     

Can pastoral counselling recover its roots in madness?

Modern pastoral counselling had its origins in North America in the experience of people, who suffered from psychiatric illnesses and who believed them to be spiritual crises, which would respond to pastoral care. In the United Kingdom many of those involved in the foundation of the pastoral care and counselling movement also worked in psychiatric hospitals. In both Europe and America pastoral counselling has largely forsaken its roots in psychiatry. However, recent research amongst mental health service users/survivors reveals how important spiritual care and counsel are and how few resources are available to provide this service from psychiatry, religious organisations or secular counselling services. The results of three research projects in Somerset are described and the significance of the recovery of pastoral counselling to fill the vacuum of spiritual care is explored.     

Counselling after Stroke: An Unmet Need?

Information was gathered by means of a questionnaire survey and interviews from a group of patients (N = 17) and health professionals (N=13) working within a stroke unit, concerning the emotional needs of patients and and their relatives and how staff responded to these needs. Although most of the staff had received some training or information about counselling and felt that their interactions with patients often involved an element of counselling, there was strong support for separate specialised counselling services to deal with psychological problems suffered by both patients and their relatives. Patients rated assistance with personal and emotional worries and advice about physical problems as equally useful. A strong need for a counselling service in some form or other was expressed by patients. Neither the level of the patients' social support nor the presence or absence of aphasia, however, predicted the strength of interest expressed. It is concluded that specialised psychological help could be useful in various ways for both in- and out-patients and for their families.     

A follow-up study on students attending a university counselling service in Northern Italy

The aims of this study were to evaluate the effectiveness of a university counselling service in Northern Italy, to assess the sociodemographic and clinical characteristics of students who used counselling service, and to assess the psychological conditions of the students who ended the counselling after a 4 month follow-up period. The study involved 100 students, who filled out the General Health Questionnaire (GHQ-12), the Brief COPE Inventory, and the Symptom Checklist-90-Revised (SCL-90-R). The results showed that who received counselling were positively affected by this experience. The areas of benefit were psychological well-being, coping behaviours, ability to positively reframe problems and less sense of guilt. Additional studies are needed to identify which factors influence the outcomes of university counselling services in Italy. These studies would be important to evaluate the services rendered, upgrade the skills of counsellors and visualise priority areas of need.     

Family therapy ‘lite’? How family counsellors conceptualise their primary care family work

A number of current developments in the field potentially provide opportunities for preventative relationship and family interventions to be integrated into primary care. In this context, it is important to understand what family counselling is and how it might differ from family therapy. Thus, this paper investigates how the service of one low-intensity family counselling provider, Relate, is conceptualised and practised by counsellors on the ground. Questions about practice were posed to five focus groups of family counsellors and these were analysed using thematic analysis. The findings suggest that Relate family counselling is seen as ‘family therapy lite’, with a flexible, eclectic and integrative use of concepts and techniques within a systemic framework. Implications of this conceptualisation of family counselling for training, practice and research are discussed.     

Getting lost

This paper seeks to explore the process, challenges and journey of setting up counselling within a boys’ public school setting, as an independent practitioner. It looks at the structure and way in which the service was set up and what had to be changed and adapted as time went on. The school had a strong reputation for pastoral care but had come to recognise that there were some issues that it was neither possible nor appropriate for school staff to deal with. So, whilst the school could and did provide containment for many of its pupils, there were those who got lost or were outside of the culture. This seemed to get reflected in my own experience. Setting up counselling in a school is not straightforward, and like the process of therapy itself, it takes time and is not a linear process. Although the service grew steadily, there were factors that led to my finally resigning from the post – I also got lost in the system. There is also a comparison with setting up a service under the auspices of an organisation at the same time.     

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.     

A five‐year evaluation of the effectiveness of person‐centred counselling in routine clinical practice in primary care

Counselling is the recommended treatment for individuals with mild to moderate mental health problems of recent onset. In this evaluation of a primary care counselling service offering person‐centred counselling, the Core Outcome Measure (CORE‐OM) was administered at referral and at the beginning and end of therapy. A pre‐post therapy effect size for 697 individuals over a 5 year period was 1.2. This compares with a waitlist (between referral and pre therapy) effect size of 0.24 for 382 individuals over a three year period. The results indicate that person‐centred counselling is effective for clients with common mental health problems, such as anxiety and depression. Effectiveness is not limited to individuals with mild to moderate symptoms of recent onset, but extends to people with moderate to severe symptoms of longer duration.     

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.     

Young people generating a repertoire of counselling psychology: Talking theory

This paper is concerned with how young people, who are trained as peer supporters in British secondary schools, construct a counselling repertoire. Issues of identity, boundaries and the dilemma of advice giving are all raised when pupils aged 14-17 talk about their roles in peer support. It becomes evident that young people's constructions of themselves and their schemes reflect the assimilation of both traditional psychological theories and contemporary counselling culture. In essence, their scheme may be marketed as a counselling/advising service, which could lead the young people to take on the role of 'counsellors'. On the other hand, their scheme may be promoted as a listening and/or support service and this will lead to young people questioning their role in the scheme. This paper will introduce these issues. This research is taken from an ongoing PhD project which uses language based research as its methodology.     

An investigation into the client at the heart of therapy

This paper reports on an exploration of the experience of the client at the heart of therapy. A grounded theory analysis of clients' experiences of therapy provided through a voluntary sector counselling service was undertaken, and generated four main categories: permission, engagement, transparency and restructuring. The results of the study are presented in a way that hopefully retains much of the richness of what people have reported about their experience of counselling. The findings of the study are discussed in terms of the idea that counselling can provide a setting where people can have common therapeutic requirements met.     

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.     

The ‘tyranny of time’: getting to the heart of the impact of educational cuts on the provision of guidance counselling in Ireland

The Irish Education Act (Government of Ireland 1998) stipulates that each young person in secondary school in Ireland is entitled to access ‘appropriate’ guidance. It has been argued that this very right has been eroded since Budget 2012, where resource re-allocations in guidance counselling are obstructing the requirement for schools to implement this section of the Act. This qualitative study explored the effects of ‘educational cutbacks’ from the perspective of guidance counsellors. Findings from interviews with guidance counsellors, suggest that the effects of such cutbacks in guidance counselling are far-reaching and ultimately students are the one’s losing out. The paper proposes that there is a need to reinstate guidance counselling hours to allow guidance counsellors provide a comprehensive service to young people – which they are entitled to.     

Secondary school pupils’ views of their school peer counselling for bullying service

Pupils (n=99) from two secondary schools in the UK were interviewed to investigate their views and experiences of the peer counselling for bullying service set up in their school. They were asked about various things concerning (1) the characteristics of the service and service providers that they valued and (2) their reasons for not using the service. Overall, a majority of participants reported a willingness to use this type of service and they identified numerous characteristics that they valued, including peer counsellors with good listening skills who were trustworthy and maintained confidentiality. A noteworthy proportion of participants also wanted the service to provide advice on solving bullying‐related problems. Some barriers to using the service were also identified, including fear of being stigmatised. Responses offered by girls and boys, and by users and non‐users of the service, were compared and several significant differences emerged. The results are discussed in terms of the implications for adults who run this type of service and the peer counsellors who deliver it.     

An analysis of the effectiveness of university counselling services

It is important to demonstrate replicable evidence of the effectiveness of counselling procedures. The study aimed to contribute to the currently limited evidence base examining the effectiveness of university student counselling in the UK. Information on therapeutic outcome [based on Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores] for 305 individuals attending a large UK university counselling service was analysed. Following counselling intervention: there was a statistically significant improvement in CORE-OM scores with 63% of individuals showing a reliable improvement and only 2% showing a reliable deterioration. Of those who began with a score in the clinical range, 49% showed a clinically significant change. These results provide additional evidence for the effectiveness of university counselling interventions. Future research should aim to build on this preliminary research using randomised controlled trial designs.     

Counsellors' perspectives on the use of the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) in an alcohol counselling setting

As part of a randomised controlled trial to investigate the feasibility of using the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) within an alcohol counselling setting, counsellors' views of using the tool were sought. Data about the service users' use of SEIQoL were collected during the counselling session, and focus groups and questionnaires were used to collect data on counsellor perceptions and experiences of using the tool. SEIQoL was easy and quick to use and provided users with a graphic, visual and dynamic means to identify important areas that contributed to their quality of life; it appeared to enhance the reflective process early on in counselling. Counsellors reported that service users requested the tool be used more frequently during the counselling process and they felt it could be a useful review tool.     

The sexual and mental health problems of street children: a transcultural preventative approach in counselling psychology

Sexual and mental health problems are on the increase world-wide especially among street children. A high proportion of vulnerable children who live in the street suffer exploitation, poor quality of life that often lead to sexual and mental health problems. Evidence is needed on the theoretical perspectives taken to address the existing gaps in counselling psychology research and practice on the plight of street children. It is also important to identify interventions that could be implemented to prevent the expansion of sexual and mental health problems among street children. Because of paucity of evidence in counselling psychology, an attempt has been made to highlight the risks factors associated with street children such as sexual exploitation, engaging in unsafe sex at an early age, promiscuity, unplanned pregnancy which tend to lead to mental health problems. Case studies are presented that illustrate the importance of a preventative transcultural approach in counselling psychology.