Statistics and economics of educational counselling in one university

An attempt is made to evaluate the cost-effectiveness of educational counselling, based on a study of a sample of 603 students attending counselling sessions in the University of Birmingham. The difficulties of finding criteria to judge the efficacy of counselling, and of controlling for other influences, are discussed. The analysis shows that 56% of the students who came for help to the educational counselling service (mostly as an 'end-of-the-road' referral, or through self-referral) have subsequently obtained degree qualifications. The current cost of 'rescuing' one student is estimated as being in the region of 29.     

Career development of counsellors

Unlike nursing or social work, counselling is not yet a statutory profession and there is no obvious career progression route. To explore the ways in which graduates of a counselling programme use their training a questionnaire was sent to 143 counselling students who had completed a minimum of Diploma level training. The questionnaires were analysed using both quantitative and qualitative methods. The key findings are that students embark on counselling training for both professional and personal development. The majority find some paid work. Many are engaged in unpaid counselling work, either solely or as well as paid work. Counsellor training is seen as providing good preparation for work but inadequate preparation for the job market. Some recommendations are made for training courses.     

The professional identity of counselling psychologists in health care: a review and call for research

Despite (a) anecdotal evidence which suggests that it is possible to be a counselling psychologist in non-traditional settings, and (b) the potential integration of counselling psychology foci with the medical model, there has been some discussion about whether counselling psychologists who practice in health care settings might experience a change in their professional identity. Professional identity is defined here as a sense of connection to the values and emphases of counselling psychology. The retention of professional identity seems important for counselling psychologists in health care settings. This is considering that the application of counselling psychology principles has the potential to make their contributions unique among mental health professionals in the health care arena. Here, the authors describe the evolution of ‘counselling health psychology’ and address issues of professional identity. Limitations of existing literature are examined. Recommendations for future research are also made.     

Online counselling in secondary schools: would students seek help by this medium?

Students in secondary schools experience problems that can impact on their well-being and educational outcomes. Although face-to-face counselling is available in most Australian secondary schools, many students, particularly boys, do not seek appropriate help. Research suggests that online counselling can be effective and increase engagement. This study of 215 secondary school students sought to assess students' intention to use online counselling if it was made available in schools. The results found no gender difference in the likely intentions to seek online help though year level was significant and students experiencing psychological distress had a preference for online counselling. If students did use online counselling it was more likely they would discuss sensitive topics rather than for career issues. Implications for school counselling are discussed.     

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.     

Clients talk about their experience of seeking counselling

The purpose of this study was to explore the help-seeking behaviour of a sample of counselling clients using a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in, affordable counselling agency located in a mid-sized city in New Zealand. Specifically, clients were asked if they had received counselling previously, what efforts they had made to solve their problems before seeking counselling and with what success, why they chose this particular agency, their initial impression of their relationship with their counsellor, and their reactions to participating in the research. The data were analysed to ascertain themes associated with their decision-making and choices. Findings were discussed in relation to the literature on seeking counselling, how clients determine their need for counselling and the process they go through in deciding when and where to get it. Implications for counsellors are discussed.     

Research as a counselling activity?: A discussion of some uses of counselling within the context of research on sensitive issues

The relationship between counselling and research strategies is examined tvithin the context of a qualitative study of people coping with the aftermath of child sexual abuse. Complementary aspects of both processes are explored within this context, and comparisons are made. The counselling potential of the research situation is identified. This is linked to the need for both researcher and research supervisor to develop additional skills.     

A counselling service for nurses in training

An account is given of the inception and development of a counselling service for nurses in training at a large London teaching hospital. The aims of the service are described, as are the evolving role of the counsellor and the use made of the service both by student nurses and other members of the hospital organisation. Some recommendations are made concerning the future development of counselling services within National Health Service hospitals.     

Research on embedded counselling: An emerging topic of potential importance for the future of counselling psychology

A significant proportion of the counselling that people receive takes place within informal, situated encounters between service users and practitioners in fields such as nursing, medicine, teaching and social work. However, almost all of the research that has been carried out into the process and outcomes of counselling consists of studies of formal, contracted counselling and psychotherapy based in therapy clinics and offices. The competent and effective delivery of counselling that is embedded in a primary professional role, such as that of nurse, teacher or social worker, presents considerable challenges for practitioners. Research evidence around the process and outcomes of embedded counselling represents a valuable resource that has the potential to enhance the quality of counselling conversations enacted by practitioners in health, education, social work and other professions. An overview is provided of different types of research that has been carried out into informal and embedded counselling, and of the main themes that have emerged from these studies. Suggestions are made for the further development of this field.     

A naturalistic longitudinal evaluation of counselling in primary care

This study evaluated the effectiveness of generic counselling in a primary healthcare setting during three months of counselling and followed up the patients' progress after counselling had finished for the next twenty-one months. Questionnaires were completed by patients within the Dorset Primary Care counselling service on referral to counselling and at set points afterwards. A naturally occurring waiting-list group was compared with patients receiving counselling at baseline and three months. Measurements were taken of patients' psychiatric symptomatology, quality of life (QOL) and self-esteem. Patients who received counselling made highly significant improvements compared with those on the waiting list. These improvements were maintained throughout the long-term follow-up. This would indicate that generic counselling has positive effects that can be maintained for a long period of time after counselling has been completed.     

Improving the quality of careers guidance: Towards an understanding of the development of personal models

The process by which careers officers develop personal models of guidance through the interaction of theoretical knowledge with their experiences of training and practice is examined. Semi-structured interviews were conducted with 11 careers officers. Questions were asked about the training and development of careers officers in the practice of careers guidance and counselling with young people. The responses are considered in relation to theories of careers choice, careers counselling and guidance, models of counselling, and the supervisory role in the development of individual practice. Some recommendations are made for improvements to training and supervision for careers guidance.     

Coping with childhood cancer: The case for long-term counselling help for patients and their families

A case is made for a skilled, independent counselling service to be made available to children with cancer, and their families. Evidence is presented from a selected review of recent literature, and the stated needs and views of a small group of parents obtained by counsellors' in-depth interviews. This evidence shows the stresses imposed, and the inability of the medical team fully to address these needs concurrently with treating the illness. Skilled, long-term counselling for patient and family is seen to be an important aspect of a comprehensive childhood cancer service.     

Telephone counselling for adolescent suicide prevention: changes in suicidality and mental state from beginning to end of a counselling session

Telephone counselling is an accessible and confidential means by which distressed young people can seek help. Telephone counselling services were funded under Australia's National Youth Suicide Prevention Strategy between 1997 and 2000. In this study, the effectiveness of telephone counselling for young people seeking help in the context of suicidal ideation or intent was evaluated in an investigation of calls made by suicidal young people to a telephone counselling service. Independent raters measured callers' suicidality and mental state at the beginning and end of 100 taped counselling sessions. Changes in suicidality and mental state were measured using a reliable rating scale developed for the study. Significant decreases in suicidality and significant improvement in mental state were found to occur during the course of counselling sessions, suggesting positive immediate impact. Limitations of the study with respect to longer-term outcomes and the relevance of the results for suicide prevention are discussed. Notwithstanding the study limitations, the results lend support for continuing development of hotline services.     

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.     

Telephone counsellors' conceptualising abilities and counselling skills

Telephone counsellors must make accurate assessments of callers' needs so as to provide appropriate counselling help or referral. But few researchers have examined counsellors' conceptualising abilities in relation to their counselling skill. Two studies involving telephone counsellors were carried out. The first relied on counsellors' post-interview conceptualisations of callers' problems and needs and found no link between the accuracy of these conceptualisations and counselling skill. The second used Kagan's Interpersonal Process Recall (IPR) to retrieve counsellors' conceptualisations made during the course of their interviews. The accuracy of these conceptualisations-in-action was related to level of counselling skill. Implications for training and research are discussed     

What difference does counselling make? – The perceptions of drug‐using clients on low incomes

Context: This paper reports on a qualitative study looking at the perceptions of clients who use drugs and are on low income. Research suggests that counselling services can experience difficulties in reaching and retaining such clients, and outcomes of counselling can be disappointing. Aim: To learn from clients who had engaged in counselling for over six months what difference it had made to their lives. Method: Grounded theory methodology was used to analyse semi‐structured interviews with six participants. Findings: Findings included changes in the clients’ internal world, their connectedness with society, their familiarity with counselling, and their perception of the relationship with the counsellor. Factors within the counselling process which helped and hindered change were identified. The study documents how participants were able to use counselling to improve their lives.     

Sturdy roots for the graceful eucalyptus: The parallel process of integrating counselling around a client's needs and aligning research paradigms with methodology

This article explores the relationship between the therapist as an eclectic clinician and the therapist as researcher. The process of finding a well-grounded place for my heuristic inquiry in academic discourse is compared with the struggle to find unity and integrity in the counselling of a client using many modalities. The intellectual and emotional struggle in either case is similar. It is posited that the engagement of students of counselling in research, therefore, has a clinical as well as an academic purpose, but that this benefit needs to be made explicit.     

Counselling in the United Kingdom: past, present and future

We chart the development of counselling in Britain since the Second World War through to the present and speculate about possible directions counselling may take in the future. Our major, but not exclusive, focus is on counselling as a developing profession and the particular role that the British Association for Counselling has played in this development. To this end, we consider some of the professional issues that have preoccupied practitioners in the field and those that may do so in the future. Thus, amongst others, we consider the relationship between counselling and psychotherapy, the costs and benefits of counselling's increasing visibility in British society, the role that supervision has come to play in the maintenance of professional standards, the debate that has surrounded the issue of counsellor accreditation/registration, the development of standards and ethics and the tension that exists between the relational and technical aspects of counselling. Counselling does not exist in a vacuum, and this is seen most strikingly in the speculations that we make about future developments of counselling. Thus, for example, we argue that counselling will have to grapple with the increasing emphasis that society places on the accountability of human services and with the inexorable progress occurring in the area of technological development. We note that counselling's response to these significant trends will have to be made against the backdrop of the continuing dissolution of barriers between previously distinct areas of human knowledge .     

Applied pluralism in the evaluation of employee counselling

The method and major findings of a complex, 'pluralist' evaluation, which investigated the effectiveness of the counselling provision of an employee support and counselling service in a local authority education department over 22 months, are outlined. Reference is made to the underlying philosophical approach of integrated pluralist evaluation, which may represent a significant step forward from the accepted methods of triangulation. In addition to achieving predicted high satisfaction rates from clients, counsellors and clients both indicated significant improvements in all measures used. These were maintained at follow-up which took place at intervals from 1 to 18 months after counselling had ended. Reduction in absenteeism post-counselling suggested the possibility of very substantial revenue savings. Responses also indicated the acute, and often chronic, need for employee counselling provision in the education system.     

The impact of waiting-list times on client attendance for relationship counselling

The impact of waiting-list times on subsequent attendance for appointments has received extensive attention within the area of health, but hitherto has received relatively little interest from counselling services. Given the current pressure on all welfare agencies for accountability and efficient use of resources, counselling organisations need to consider resource usage and barriers to efficiency. A study was therefore made of one aspect of this issue: the impact of short v. long time-delays between initial referral and first appointment for relationship counselling. It was found that clients offered appointments within two weeks of referral were significandy more likely to attend for first appointment than were clients whose appointment came between 4 and 12 weeks post-referral. The implications of these results for organisational policy are discussed.