An Evaluation of Training in Basic Counselling Skills

A 60-hour course to train community-health professionals in the basic skills of counselling families of children with disabilities was evaluated. Three groups of diverse professionals (25 females and 1 male in all) were trained. The overall approach followed the didactic-experiential programme of Truax and Carkhuff (1967). Teaching methods included discussion, role-play, and feedback. Hypothesised changes occurred in trainees as a result of the course in contrast with a non-training waiting period. There were significant improvements in theoretical knowledge, self-perceptions of counselling ability and counselling behaviour. Evidence from a sub-group of the sample indicated that changes were maintained for up to nine months afterwards. The validity of the results is further supported by a separate study demonstrating benefits in families with whom the trainees subsequently worked. It is concluded that such courses are cost-effective in enhancing the professional skills of health-care workers.     

From Constraints to Opportunities? Provision of Psychosocial Support in Portuguese Oncogenetic Counseling Services

Although available guidelines for familial cancer risk counseling clearly state the need to provide adequate psychosocial assessments and support, this feature of care is only available in part for individuals and families in oncogenetic counseling protocols in Portugal. The purpose of this study was to examine the psychosocial aspects of oncogenetic counseling provided by a sample of Portuguese genetics professionals. We sought to ascertain perceived need for the provision of psychosocial services and ways to enhance the psychosocial focus in service delivery. A qualitative study was designed; semi-structured focus groups and individual interviews were performed with 30 professionals from Portuguese healthcare institutions where oncogenetic counseling is offered. Findings suggest: current practice is aligned with the teaching model, with a mainly information-based focus; use of psychosocial counseling techniques and psychosocial support is limited throughout the genetic counseling timeline; there is a limited workforce of adequately trained psychosocial professionals, who are disadvantaged by structural and organizational constraints. These factors are considered to be serious barriers for psychosocial delivery. Development of multidisciplinary teams working in oncogenetics, and need for further counselling skills and training for genetics healthcare professionals were identified as priorities. Implications for practice and policy are discussed. Portuguese genetic counselors who have recently completed their training, may therefore contribute to enhanced psychosocial services delivery.     

Evaluation of a counselling skills course for health professionals

A counselling skills course run by a London hospital for 11 health professionals was evaluated. The course covered family counselling skills and child management techniques. Qualitative and quantitative measures were used at five times of testing over a period of 10 months. It was found that participants improved self-perceptions of their counselling ability, increased their knowledge of counselling theories, and considered the course to be helpful in their subsequent work with families. There was no significant change in trainees' self-concept scores. Regular supervision was regarded as helpful in consolidating skills and exploring aspects of practice in a safe environment. Issues relating to evaluation research are discussed.     

More than expected? Psychological outcomes from first-stage training in counselling

This study considers psychological outcomes of first-stage counselling training for nine annual student cohorts. A self-report questionnaire, with both open-ended and closed questions, was employed to investigate initial course expectations, what had been learned about self, and any perceived changes in attributes and skills and in relationships with family, friends and others. Eighty-six out of a total of 148 students returned questionnaires, a response rate of 58%. Students reported having learned more about counselling theories and skills, as they had expected initially, but results show that other important outcomes had been largely unanticipated. Many, for example, felt that, as a consequence of course participation, they had a deeper understanding, and greater acceptance, of self and that a range of attributes and skills, such as sensitivity to others and communication skills, had been enhanced. For many, these outcomes had led to improved relationships with family and friends, and also, for some, with work colleagues. It is concluded that, in this example of introductory counselling training, the course experience had led students to discover more about self and had also impacted on different facets of their lives.     

Ripples in the pond: A qualitative study of graduates' perceptions of the impact of counselling training upon their work within the core professions

A small-scale qualitative study was conducted in order to examine the value of counselling training when incorporated into a person's established professional role. Questionnaires were sent to graduates from an MA/diploma in counselling course in order to identify those who had continued working within their core profession. This was followed by in-depth exploration of the issues through a focus group and interviews. Twelve respondents, from a variety of work settings, took part in this second stage. Results indicated that counselling training had impacted on all aspects of their work role and that there can be a benefit of such training in the workplace. Participants developed a tripartite understanding with regard to the self, clients and the organization, and change was experienced in each of these three dimensions. A larger-scale study, among graduates from a number of courses and also among employers, is indicated.     

The good,the bad and the uncertainty: Trainees' perceptions of the personal development group

Background: Views about the purpose and role of personal development groups (PD group) in the counsellor training process are varied. Some argue they enhance self‐awareness, self‐exploration, the ability to be congruent and, ultimately, that they make for better practitioners. Others argue there is no clear evidence for such benefits and that they can actually be damaging to trainees. Aims: This study aimed to explore the beliefs of 25 trainees enrolled on counselling diploma or counselling psychology doctoral courses. It looked in particular at their perceptions of the purpose of PD groups and their expectations regarding support, difficulties and the scope of their participation. Method: Data was collected using open‐ended questions in an anonymous survey and was subjected to a thematic analysis. Results: Trainees appeared to hold mixed – and sometimes conflicting – views about the PD group. For some it was a positive endeavour that facilitated learning about self and clients, and helped in the processes of developing counselling skills and keeping the training group healthy. For others it was a feared space, which could elicit negative emotional experiences, and impact negatively on both learning outside of the PD group and the health of the group itself. Still others were unclear about its purpose. Hope/idealisation (of the process, the facilitator and course tutors) were also evident in the trainees' responses. Implications: Implications of these findings for counselling training are discussed.     

Experimentation with Group Techniques with Ego-Disturbed Mothers

Abstract

Psycho–educational groups (PEGs) have been shown to be a particularly effective form of treatment for patients classified under the rubric of severely and persistently mentally ill (SPMI). However, recent surveys suggest that certain professionals, such as nurses and clinical psychologists, called on to conduct these groups may have limited to no training. This study tested three methods (self–instructional, workshop, and workshop plus clinical supervision) designed to provide on-the-job training to practicing clinicians. Specifically, training was based on two manuals; one that operationalized the basic knowledge and skills needed to run an effective PEG and the second being a commonly used PEG program for symptom management targeted at SPMI patients. Eight nurses from four adult units at a state psychiatric hospital initially received self–instructional or workshop training and then conducted a 12–session symptom management PEG composed of four to five SPMI patients (e.g., schizophrenia, schizoaffective or major depression disorders). In a second wave of additional training, nurses received workshop training or clinical supervision and then conducted a second PEG. Differences between training methods were assessed by nurse– and patient–completed measures that tapped the knowledge and skills emphasized in the symptom management and PEG (nurses only) manuals. Results indicated limited support for the superiority of the workshop method on the nurse measures alone. Implications for training working professionals in group treatments and assessing outcomes with chronic SPMI patients are discussed.     

Tools for Many Trades: Reaffirming the Use of Grief Counselling by Health, Welfare and Pastoral Workers

The use of counselling is increasingly questioned as an appropriate and viable activity for professionals in statutory and general settings whose work roles and tasks are varied. This paper looks specifically at grief counselling and examines some of the reasons why applications of grief theories and grief counselling by such workers have been narrow and limited. It then suggests a framework for teaching the subject, offering relevant applications. Finally, it points to developing areas of grief counselling in multi-disciplinary contexts and argues that working with grief and loss must be recognised and fostered as core, generic skills for the non-specialist.     

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.     

Addressing disparities: The impact of a lesbian,gay, bisexual,and transgender graduate counselling course

Background: Lesbian, gay, bisexual and transgender (LGBT) individuals experience serious mental health disparities and treatment inequities. Counsellor education has been identified as both a contributing factor to these problems as well as an ameliorating mechanism to address these inequalities. Aim: The purpose of the current study was to evaluate the impact of an LGBT‐affirmative counselling course. Method: A total of 23 students enrolled in a graduate LGBT counselling course were administered the Sexual Orientation Counselor Competency Scale (SOCCS, Bidell, 2005) and the Lesbian, Gay, and Bisexual Affirmative Counseling Self‐Efficacy Inventory (LGB‐CSI, Dillon & Worthington, 2003) pre‐ and post‐course. In addition, a comparison group of 23 matched counselling students was obtained from an existing data source in order to make further assessments of the course's effectiveness. Those in the comparison group were not enrolled in the LGBT course, but were administered the SOCCS at analogous time intervals. Results: After completing the LGBT course, enrolled students demonstrated significant improvements regarding their sexual orientation counsellor competency and self‐efficacy. In addition, these students showed significant gains in SOCCS scores versus those in the comparison group. Implications: Results from this study show the positive effect a full‐credit LGBT psychotherapy course can have on graduate counselling students' sexual orientation counsellor competency and self‐efficacy. The findings also indicate that such a course can significantly impact counselling skills, a facet of LGBT cultural competency found to be the most attenuated. Findings are discussed in conjunction with LGBT‐affirmative counsellor training and clinical practice.     

A qualitative study of client experiences of working with novice counsellors

Aims: This paper reports on a qualitative analysis of written accounts by clients who participated in a counselling relationship with beginning-level trainees. The purpose of the study was to explore how clients experience the process of counselling with novice practitioners. Method: Consensual qualitative research was used for data analysis. Findings: Three general thematic categories were identified – client perceptions of self in counselling; client perceptions of the counsellor; and client perception of the counselling process. Conclusions: Overall, the findings suggest that these clients saw the interpersonal qualities and skills of the counsellor as major contributors to their experience. Implications: Clinical training of novices should start by developing the interpersonal and collaborative skills of trainees.     

Training for paraprofessional counsellors: Evaluating the meaning and impact of a common factors approach

A group of 12 people participated in a short (40 hours) counselling training programme for paraprofessional counsellors, which emphasised the importance of common factors in accounting for therapeutic effectiveness. The general framework, language and skills of a brief, solution‐focused approach was used as a means of translating the theoretical/conceptual ideas of the common factors model into specific counsellor behaviours and also to provide structure and focus for counselling sessions. A pluralist methodology was employed to assess the personal meaning of the training for participants and the impact of the training on the development of counselling skills and awareness. Results indicated the training impacted positively on the development of counselling skills and ability to handle difficult client behaviours but less so on personal values and ability to deal with process issues. The majority of participants believed the training contributed positively toward their personal development.     

From teaching to counselling: An evaluation of the role of microcounselling in the training of school counsellors

During the past 20 years the use of microtraining as a method for training professionals in communication skills has attracted considerable attention. In this paper, the microtraining approach is explained briefly, in terms of the development of microteaching and microcounselling, as a means of training teachers and counsellors respectively. One interesting aspect of the training of teachers is then focused upon, namely the use of microcounselling in the preparation of in-service teachers for the role of school counsellor. The nature of teaching and counselling activities are compared and contrasted, and the resultant difficulties in training teachers to act as counsellors are high-lighted. Finally, a number of procedures for trainers involved in such training are listed, whereby teachers can be encouraged to more readily adopt a style of behaviour appropriate for the counselling context.     

Online Cognitive Behavioural Therapy Training for Therapists: Outcomes,Acceptability, and Impact of Support

The objectives of the present study were to assess the effects of online cognitive behavioural therapy (CBT) training for therapists on measures of CBT knowledge, skills, confidence, and utilisation; to determine what differences might exist between a group supported by regular telephone contact and an independent group who undertook online training without additional support; and to determine the acceptability of CBT online training among rural and remote mental health professionals. Mental health practitioners were randomly allocated to a supported training group (six sessions of 15‐min support) or an independent group. They undertook a 12‐week online CBT training program. The two groups showed similar gains on an objective test of knowledge of CBT, and on self‐report measures of knowledge, skills, confidence levels, and utilisation of skills. However, the supported training group had a significantly higher program completion rate than the independent group. Participants evaluated the program favourably. The results suggest that online CBT training represents a promising and cost‐effective approach to training the mental health workforce, and may be particularly attractive for those who live in regional, rural, and remote communities. A challenge is to determine the most cost‐effective ways to enhance program completion rates and trainee skills.     

Maintenance of Parent-Implemented Discrete-Trial Instruction during Videoconferencing

Access to behavior-analytic professionals who can implement interventions like discrete-trial instruction (DTI) may be limited for families living in rural communities. We trained four rural parents of children with autism to implement DTI accurately with a confederate using in vivo behavioral skills training. The DTI skills that parents demonstrated with a confederate generalized to working with their children. We then assessed whether periodic supervision during videoconferencing maintained parents’ DTI skills following training. Parents accurately implemented untrained DTI programs with their children and maintained accurate implementation over several months of remote supervision occurring twice a week, weekly, and biweekly. Videoconferencing may be an effective way for individuals responsible for direct implementation to maintain contact with behavior analysts who are not locally accessible.     

Increase in counselling communication skills after basic and advanced microskills training

Background Mastering counselling communication skills is one of the requirements that lead to the diploma of a registered European psychologist. The microcounseling method proves to be effective in training these skills. Aim Research into the effectiveness of the microcounseling method often reports overall effect sizes only. The aim of this study was to investigate the adequate use of separate counselling communication skills (seven basic skills: minimal encouragements; asking questions; paraphrasing; reflection of feeling; concreteness; summarizing; and situation clarification and five advanced skills: advanced accurate empathy; confrontation; positive relabelling; examples of one's own; and directness) after respectively a basic and an advanced training in these skills. Sample Participants were 583 first year or second year bachelor students in psychology who took the counselling communication skills progress test (CSPT). The participants are divided in a group of freshmen, who had not received any training in counselling communication skills; first year students, who had received a training in basic skills; second year students who had followed a training in advanced skills and a control group. Method A between‐subject design, a within‐subject design and a pre‐test–post‐test‐control group design were used to examine the scores on these skills. Results Seven basic skills and four advanced skills had large effect sizes. One advanced skill had a moderate effect size. Conclusio The microcounseling method is very effective on the level of separate microskills. However, students perform better on the basic skills than on the advanced skills. More training seems to be needed in the latter to achieve the same level of mastery.     

Counselling psychology in primary health care: A review

This paper reviews the development of counselling psychology within the field of primary health care. Issues discussed include liaison between counselling psychologists and other professionals, evaluation of treatment in primary care, family therapy in general practice and general practitioners’ skills in counselling. The need for training and evaluation of counselling are discussed and suggestions are made for further research.     

Cancer counselling in the United Kingdom

Abstract

A national survey of 289 people from a variety of professions (nurses, social workers, clinical psychologists, psychiatrists, etc) involved in counselling cancer patients and their families within the United Kingdom obtained a response rate of 82%. The primary findings discussed in this paper cover a range of issues, including the working conditions and responsibilities of the counsellors, what professional qualifications they possess, the extent and availability of supervision and support, as well as the types of counselling intervention employed. Particularly disturbing was the fact that only 25% of our sample had any recognised formal counselling qualification and that 75% did not belong to any professional counselling organisation. In view of the wide diversity of qualifications, salary scales, responsibilities and working conditions and practices amongst the respondents, we propose that the National Health Service (NHS) should establish clearer guidelines as to the minimum acceptable qualifications for people employed as oncology counsellors, and that more adequate provision and resources are made available for training and supervision.     

Training self‐assessment and task‐selection skills to foster self‐regulated learning: Do trained skills transfer across domains?

Students' ability to accurately self‐assess their performance and select a suitable subsequent learning task in response is imperative for effective self‐regulated learning. Video modeling examples have proven effective for training self‐assessment and task‐selection skills, and—importantly—such training fostered self‐regulated learning outcomes. It is unclear, however, whether trained skills would transfer across domains. We investigated whether skills acquired from training with either a specific, algorithmic task‐selection rule or a more general heuristic task‐selection rule in biology would transfer to self‐regulated learning in math. A manipulation check performed after the training confirmed that both algorithmic and heuristic training improved task‐selection skills on the biology problems compared with the control condition. However, we found no evidence that students subsequently applied the acquired skills during self‐regulated learning in math. Future research should investigate how to support transfer of task‐selection skills across domains.