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.     

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.     

Advertised Australian counselling psychologists: A descriptive survey of their practice details and self perceived competence in six counselling psychology practice areas

This survey research in a field setting aimed to describe psychologists who advertised themselves in the Australian Yellow Pages as counsellors, thus providing a snapshot of advertised counselling psychologists in Australia. Data was collected using a multiple mailing survey method and resulted in a 62.2% return rate. The psychologists’ (a) demographic characteristics, (b) training and development, (c) provision of services, (d) professional involvement, and (e) their self perceived competence in working with (i) depression, (ii) anxiety, (iii) substance use, (iv) clients from non English speaking backgrounds and Indigenous and Torres Strait Islander individuals, (v) clients who are same sex attracted (gay, lesbian, and bisexual individuals), and (vi) clients using electronic mail and instant messaging were assessed. Advertised Australian counselling psychologists tend to be female, mature and Caucasian. The majority of the psychologists surveyed live in urban areas. Master and Bachelor level degrees were most often reported, a minority held doctoral degrees. The average psychologist charged $96.32 per hour, less than the Australian Psychological Society (APS) recommended fee for an hour of service. Eclectic and cognitive behaviour therapy were indicated most often as the theoretical orientations guiding psychological work. Psychologists belonged almost exclusively to the Australian Psychological Society as a professional association. Surprisingly, 2.9% of psychologists indicate not following an ethical code in their work and 3.9% failed to ensure that their work was covered by professional indemnity insurance. Advertised psychologists are thus described and suggestions are given for the further development of the profession. Regarding their self perceived competence, Australian advertised psychologists present as having self perceived strengths and areas of weakness regarding their counselling competence. This indicates that they are aware of their varying ability to work with various issues and populations. The self perceived competence of Australian psychologists in six specific counselling practice areas and suggestions for future training and development are provided.     

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.     

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.     

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.     

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.     

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.     

Working with differences: Issues for research and counselling practice

This paper considers our experience within a group researching domestic violence in minoritised groups and the implications for counselling practice. Issues of race, gender and power were significant within the research team. These issues are intrinsic to minoritised women's experiences of service responses and are also a powerful, yet often unexplored, dynamic in counselling practice. We reflect on issues of ‘outsiders’ and ‘insiders’ in terms of the research process and findings, and the impact and influence of these power roles on counselling practice. We acknowledge that it is only by retrospectively engaging with each other and our differences that we have been able to explore our parallel processes and consider their implications for counselling practice.     

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.     

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.