Public perception of the professional titles used within psychological services

Background and aim: There have been several calls for adopting an empirical approach investigating public opinion concerning the differentiation between the professional titles ‘counsellor’ and ‘psychotherapist’. The present research makes a first step to addressing this issue. Method: Sixteen interviewers, recruited across the UK, interviewed 450 members of the public in 57 UK district codes. Age, gender and education were monitored for sampling purposes. Results: The findings indicated that around two thirds of the public perceive the professional title ‘counsellor’ to be distinct from the professional titles ‘psychotherapist’ and ‘psychological therapist’ and for these latter two titles to be almost identical. About one third of the public perceive the opposite trend, and one tenth is undecided whether these professional titles are distinct or indistinct. Conclusion: These results have implications for the debate concerning the structure of the Health Professions Council (HPC) Register in the regulation of counsellors and psychotherapists.     

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.     

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.     

The relevance of research in counselling and psychotherapy for the counselling practitioner

Current research paradigms are outlined and appraised to enable counsellors to see more clearly the practical relevance of counselling research. The standpoint taken is that although it is possible to criticise current research paradigms on a number of grounds, practitioners who know their own biases and the limitations of these paradigms can successfully experiment with interventions suggested by research in their own practice. An example is presented from the research on paralinguistic variables in client-centred therapy.     

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.     

The challenge of counselling and psychotherapy research

Aims: The purpose of this commentary is to argue that the value of counselling and psychotherapy research lies, not only in what it teaches us as therapists, but also in its ability to challenge us and our assumptions. Method: The paper identifies eight beliefs that may be prevalent in sections of the counselling and psychotherapy community, and presents evidence that challenges them. Findings: While many of our beliefs may hold true for some clients some of the time, the research evidence suggests that they are unlikely to be true for all clients all of the time. Discussion: By questioning and challenging therapists' a priori assumptions, research findings can help counsellors and psychotherapists to be less set in their beliefs; and more open to the unique experiences, characteristics and wants of each individual client.     

Theory‐building case studies of counselling and psychotherapy

In addition to their potential for healing, psychotherapy and counselling offer extraordinary opportunities to observe human experience and behaviour. I suggest practitioners have expertise in and daily access to the phenomena that theories of counselling and psychotherapy seek to explain. Practitioners’ clinical experience can be accumulated and shared through theory-building case study research. This article summarizes the logic of theory‐building case studies and offers practical suggestions for conducting case study research.     

The baby and the bathwater: 'Professionalisation' in psychotherapy and counselling

The current rush to professionalisation in the field of counselling and psychotherapy, and some of its deleterious effects, are examined. The parallels between this process and the experience of psychoanalysis in the USA in the 1940s and early 1950s are demonstrated, quoting from contemporary critics; and comparisons are drawn with the American phenomenon of managed care. An account is offered of what is happening in terms of the sociology of professions, suggesting that 'expert systems' are being substituted for 'local knowledges—skills and wisdoms which cannot be fully systematised. The argument that this process is for 'the good of the client' is considered and rejected. Finally, some thoughts are presented about the likely future for counselling and psychotherapy, arguing that the victory of professionalisation and expertise is unlikely to be complete.     

Barriers and challenges in the practice of multicultural counselling in Malaysia: A qualitative interview study

Counsellors face a lot of problems and stressors in their daily lives. As a person, counsellors may face challenges to deal with their personal expectations and responsibilities in life, work, family and community. As a professional, counsellors may face difficulties in dealing with professional issues and ethical dilemmas in their professional practice such as countertransference and value conflicts. These raise issues concerning their perceived multicultural competence and the adequacy of their training. Informed by a multicultural counselling perspective and drawing on semi-structured interviews with 12 professional counsellors in Malaysia, this study discusses the types of barriers and challenges faced by Malaysian counsellors and how these challenges were manifested and addressed in the cross-cultural counselling sessions. Results revealed five emerging themes based on participant counsellors’ responses on the barriers and challenges encountered in their practice of multicultural counselling in Malaysia. These were challenges related to counsellors’, clients’, presenting issues’, third-party and specific contexts’ characteristics. Research implications for the education and training of counsellors in the specific Malaysian socio-political context are also discussed.     

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.     

Social and political perspectives on the psychotherapy and counselling profession: Returning caravelles

The counselling and psychotherapy profession is changing. For the first time in its history, it has begun to receive substantial Government funding in the UK and it also has to contend with the principles of evidence-based practice and the policies of the New Public Management systems in many countries. This paper argues that such recent developments present challenges to the profession’s historical apolitical standpoint. More importantly, it argues that the present social and political climate offers many opportunities such as the possibility of learning from psychosocial practices in other countries. The paper will look, in particular, at what can be learned from Latin America and India where mental health care and psychological therapy have adopted grassroots involvement, health-focused approaches and innovatory therapeutic methods.     

Better together: a unified perspective on appraisal and emotion regulation

ABSTRACT

Advances in our understanding of appraisal processes and emotion regulation have been two of the most important contributions of research on cognition and emotion in recent decades. Interestingly, however, progress in these two areas has been less mutually informative than one might expect or desire. To help remedy this situation, we provide an integration of appraisal theory and the process model of emotion regulation by describing parallel, interacting and iterative systems for emotion generation and emotion regulation. Outputs of the emotion generation system are perceived by the emotion regulation system, and emotion regulation strategies then modulate emotion by intervening at specific stages of the emotion generation system, ultimately changing appraisal dimensions. We hope that our unified perspective will encourage and guide future research at the interface of cognition and emotion.     

依恋对情绪调节过程的影响

以依恋理论为基础的研究已证明依恋对情绪调节的影响,但这些研究忽视了情绪调节作为一个过程的复杂性和多样性,因此现有研究无法回答依恋为何会对情绪调节产生影响。扩展过程模型将情绪调节分为三个阶段,并清晰地描述了情绪调节的过程以及过程中各因素之间的关系。从该模型来看,在情绪调节的三个阶段均可发现与依恋有关的个体差异,并且依恋对于情绪调节早期阶段的影响可能是导致后期阶段产生个体差异的原因。未来的研究应在探讨依恋对情绪调节的影响的同时关注环境因素的影响;设计新的实验范式以证实情绪调节三阶段的连续性并探索依恋影响情绪调节的潜在机制;探讨依恋对情绪调节灵活性的影响。此外,未来的干预研究应设计更具针对性的干预措施来改善非安全依恋个体的情绪调节。     

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.     

Brief psychodynamic psychotherapy in adolescent depression: Two case studies

In this paper the authors outline the basic principles of a manualized, brief psychodynamic approach that was evaluated as part of an outcome study within the National Health Service researching the effectiveness of two different forms of psychotherapy for major depression in childhood/adolescence: Focused Individual Psychodynamic Psychotherapy and Systems Integrative Family Therapy. As well as describing some of the difficulties encountered in short-term dynamic psychotherapy with adolescents, the authors present therapeutic work with two adolescents with major depressive disorder who were both seen as part of the research study. The authors depict some of the challenges and unavoidable difficulties which emerged during the therapy, arising from the needs of the research programme.     

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.     

Coming to terms: Client subjective experience of ending psychotherapy

How do clients consider their own contribution and that of their therapist in the last phase of therapy when they are moving toward the end? Thirty-seven clients who had received therapy from highly experienced clinicians were interviewed. Since the time for ending had not been decided at the onset, clients in both short- and long-term therapies were included. Thematic case-by-case analyses were carried out. Clients actively engaged in looking back and looking ahead, as means of reflecting on their capability to handle issues on their own. The majority of clients were satisfied with what they perceived as a reciprocal engagement that enabled them to come to terms with emotionally charged issues in life and in therapy. For some clients unresolved issues remained: wondering whether a therapist with another approach could have helped more; feeling pushed away by the therapist; having to take the lead in ending therapy; the fear of being an “unworthy” client; or wanting to end without the therapist’s approval. Coming to terms with the ending of therapy was highly personally meaningful and loaded with affective tensions, in ways that were not always shared with their therapist.