Genograms in counselling practice: Constructing a genogram (part 2)

In Genograms in counselling practice: a review (part 1), recent literature on the use of genograms was reviewed and the efficacy and utility of genograms in counselling practice was examined. This paper outlines how a family genogram is constructed in a counselling setting. An approach to introducing the relevance of a genogram to the client is described as is the method of gathering and using information. The therapeutic use of genograms is also discussed.     

Getting curious about meaning-making in counselling (1)1

Counselling offers many experimental opportunities from which counsellors can learn and develop their meaning-making skills. Recent developments in qualitative research, and in social constructionist approaches to counselling, point to new ways of conceptualising the conversations of counselling and guidance. In particular, a hermeneutic view of counselling attunes counsellors and guidance practitioners to the particular meanings and meaning-making potentials clients and students bring to counselling and guidance conversations. Accordingly, our questions and proposed solutions can be seen as engaging the meaning-making efforts of clients in ways we, and they, can learn from. Our conversations offer many potential experiments in meaning-making, should we think of what others do with what we say—as occurring across a gap of conversational potential. This article explores ways to adopt, and learn from, such a hermeneutic frame in our conversations with clients and students.     

Non-directive counselling in a general practice

Many patients in general medical practice are not ill in the physical sense, but bring their unhappiness to the surgery. An experiment is described in which a counsellor was attached to a general practice in north London, to help to deal with problems of this kind.     

Searching for integration in counselling practice

The search for integration in counselling practice is addressed. It is argued that this necessarily involves a process of dialectical thinking, brought to bear in reconciling different visions of reality encapsulated within divergent therapeutic traditions. A model is offered of integration based upon the superordinate concept of 'the vicious circle' derived from an ironic world-view. The model is heated in Wachtel's theory of cyclical psychodynamics and Bowlby's attachment theory. An illustrative case-study is provided.     

Counselling in general practice: A review

The development of counselling has brought enthusiastic attempts to pioneer its application to a diversity of fields. One obvious target has been primary-care and the general practitioner's surgery, where there has been an increase in demand for help with 'life-problems' and a growing reluctance to prescribe drugs of doubtful benefit. The need for both time and expertise to respond appropriately has made counsellors welcome additions to many surgery teams. However, different professions and volunteer groups compete for the role; each cites evidence of its own appropriateness, rarely acknowledging, and never assessing, the contributions of others. Hence this attempt to bring together the findings of these disparate groups to demonstrate their undoubted similarities and to assess the value of 'counselling' intervention in general practice.     

Boundaries in the practice of humanistic counselling

The multifaceted concept of boundary is used to describe the ground rules, quality and type of therapeutic relationship in a humanistic form of counselling that develops some of the principles of Carl Rogers and blends them with principles from psychodynamic practice. The concept of boundaries is first discussed in relation to its usages and practical consequences. An analysis of some core principles and assumptions about boundaries that guide the communicative psychotherapy approach of Robert Langs leads into a comparison with person-centred counselling. The aim is to develop a middle path for humanistic practice along more formal lines, involving a more fluid understanding of relationships and precise use of counselling principles. This also involves finding aspects of agreement between the psychodynamic and humanistic styles of working, by omitting some concepts and practices and identifying areas of common ground. Several comments on practice are made by comparing the two perspectives. The concept of boundary enables counsellors of all schools to think about points of similarity and difference. Finally, the notion of boundary itself is critiqued, and intersubjectivity is proposed as a potentially more meaningful term.     

Critical thinking and reflective practice in counselling

Human Behaviour is Gouerned by Assumptions and Beliefs (What Argyris Calls ‘Theoryin-Use’), Yet Individuals Commonly Explain Their Behauiour in Terms of a (Different) ‘Espoused’ Theory. It is Suggested here that Reflective Practice in Counselling Can Only be Achieued by Counsellors Identifying Their Own Theories-in-Use Through a Process of Critical Thinking. The Task of Counselling in this Process is for the Counsellor to both Become a Critical Thinker and Enable His/her Client to Become One.     

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.     

Marriage guidance counselling in general practice in London

People with marital difficulties are more likely to contact their GP for help than any other social service. In recent years, a number of attachments of marriage guidance counsellors to general practice have been set up to encourage doctors to refer patients directly. This paper describes the results of a postal survey of general practitioners and counsellors in attachments in the area covered by the London Marriage Guidance Council. While the results were very positive, with few disadvantages mentioned, it must be remembered that the majority of GPs involved were a highly self-selected and atypical group, usually with a special interest in psychotherapy.     

Developing practice and evidence for counselling in primary care: the agenda

Counselling in primary care has developed rapidly over the last few years and now appears to be a widespread provision. Yet ad hoc , unregulated development, coupled with radical changes within the National Health Service environment, presents an array of challenges to continued development. This paper reviews and summarises the contributions of all the authors to this special symposium, and in so doing attempts to set out a development agenda for both evidence and practice as a practical yield from the rich insights and experiences offered.     

Globalising counselling: humanistic counselling in Kenya

This paper explores the application of a Western, psychologically-based model of counselling and counselling training in contexts where the social and cultural conditions differ from mainstream Western societies. A group of Kenyan trainee counsellors following such a course are interviewed about their experience of training. The interview data are analysed to provide a tentative answer to the question of the appropriateness in a Kenyan cultural milieu of a humanistic counselling training model developed in the UK. It is concluded that such application is possible and desirable, if it is undertaken as shared and respectful learning between trainers and trainees.     

Career counselling: A process in process

Career counselling, career guidance, and career interventions are terms in the process of evolution. Historical and contemporary factors in the US experience that have changed and expanded the needs for career counselling and related career interventions are discussed. For many work-adjustment problems, in particular, there is a growing acknowledgement that career and personal counselling must fuse. Where this fusion occurs, on a continuum from choice, indecision, and situational concerns to change, indecisiveness, and personal concerns, is analysed.     

(Re)placing multiculturalism in counselling and psychotherapy

Since multiculturalism is not fully theorised it has created much confusion in counselling and psychotherapy. It has been criticised for ignoring questions of power relations, and for emphasising the cultural differences of ethnic minority groups rather than focus on their similar predicaments of racism, sexism, misogyny, homophobia and economic oppression. Furthermore, it has not provided clinically useful information within which therapists can conduct assessments and diagnosis, understand clients' subjective distress and cure seeking expectations. This paper explores this issue by highlighting the magical (non)sense of multiculturalism and its racialised forms, and argues that multiculturalism is untenable if it restricts itself to a few marginalised ethno-cultural client groups, rejects gays and lesbians, patronises indigenous forms of healing, and maintains a fixed racialised 'black-white' paradigm of practice. It suggests that a point of departure for multiculturalism from an ethno-culturalism-centred philosophy to one that is pluralistic and reflexive of the needs of all clients (irrespective of ethnicised, racialised, gendered, and sexualised subjective identities) is critical if it is to be useful psychologically. To arrive at this critical juncture, multiculturalism would need to be (re)placed, not disavowed but re-centred in the practice of counselling and psychotherapy to embrace diversity and difference across and beyond the current categories that constitute itself. Replacing multiculturalism in a 'third space', an 'in-between space'—a critical multicultural space—where dominant hegemonic cultural meanings could be reinscribed and where racism, sexism, misogyny, homophobia and other 'representations of patriarchal terror' could be critically interrogated to empower marginalised voices. The paper explores three strategies for creating a 'third space' in multicultural counselling and psychotherapy: the inclusion of white people as clients; the converging of race, gender, sexual orientation, class and disability issues; and the integration of indigenous and traditional healing practices. Bringing it all together under the umbrella of diversity or critical multiculturalism will ensure an ethical and clinical practice commensurate with our current understanding of the complexity and sophistication within which clients construct their subjectivity.     

Clients' suitability for counselling: The perception of counselors working in general practice

This study investigated the attitudes of 112 counsellors in general practice towards various factors concernig the selection of clients. Response indicate that counsellors are influenced, not only by diagnostic criteria, and other factors relating to the client, but also issues relating to the counsellor and the setting in which she or he works. The diagnostic critreria whcih seem to be considered most important are desire for change, motivation for therapty and evidence of psychopathology, althoug there is no clear consensus about the criteria overall. Importance varied according to the age and sex of the counsellor, but not by the experience, training, model of working, desire for further training, or number of sessins available.