Working for free: A fundamental value of counselling

This paper challenges two myths about voluntary sector counselling, namely (a) that volunteer counsellors and voluntary sector counselling are the same thing, and (b) that standards of practice in the voluntary sector are significantly different from those elsewhere. The paper also argues that voluntary sector counselling nurtures a deeply felt commitment to respond to human need without monetary recompense. Drawing on evidence from a study of voluntary sector counselling in Scotland, we show that a substantial proportion of voluntary sector counselling is undertaken by paid workers, and that many counsellors who volunteer in one setting undertake paid counselling work in another setting. We demonstrate that the majority of voluntary sector counselling agencies in Scotland work within ethical frameworks developed by the professional bodies for counselling, and we argue that these agencies have been at the forefront of efforts to enhance the quality and safety of counselling services available to the public. We identify and illustrate three overlapping reasons why large numbers of highly qualified counsellors give their time and expertise for free: because of their desire to support the work of agencies through which the accessibility of counselling is extended; because volunteer counselling constitutes personally rewarding and meaningful work; and as an expression of their commitment to give freely of themselves. In conclusion we argue that voluntarism is central to counselling, but that parts of the counselling world are at risk of forgetting this core value.     

A profile of counsellors working in non-statutory alcohol services

There are 39 voluntary sector alcohol agencies in the UK who meet minimum standards of counselling set out by the national organization Alcohol Concern through their Volunteer Alcohol Counsellors Training Scheme (VACTS). This paper reports on a study to create a profile of volunteer counsellors who work in VACTS-recognized agencies. Fifeen agencies agreed to take part in the study, and 141 counsellors completed and returned a mailed survey questionnaire, to elicit information about demographic characteristics, current and previous counselling training, reasons for undertaking the VACTS training and level of experience within agencies. The results suggest that this cohort of counsellors tend to conform to the volunteer stereotype of the middle-aged middle-class woman. Many counsellors utilize their experience within agencies to develop counselling skills, often in connection with further counselling courses, or to consider a change in career direction. Some counsellors wish to use personal experience of alcohol problems to help others undergoing similar difficulties. In contrast to those in the generic volunteer field, counsellors appear to retain long-term involvement with their agencies. The study concludes that alcohol services in the UK rely greatly upon a group of committed and competent volunteers to deliver individual counselling to problem users of alcohol.     

A feasibility study of the systematic evaluation of client outcomes in a voluntary sector counselling agency

There is an increasing demand on voluntary sector counselling agencies to evaluate the effectiveness of their work with clients. A pilot study was carried out in a voluntary sector counselling agency to assess the feasibility of adopting a well‐established evaluation system (CORE) designed to measure client outcomes. The paper describes the issues and complexities involved in introducing such a system, and explores the impact of the evaluation on counsellors, staff and users of the service. It is suggested that evaluation can play an important role within voluntary organisations in enabling counsellors and staff to reflect on their work.     

How effective are minimally trained/experienced volunteer mental health counsellors? Evaluation of CORE outcome data

Background: Existing research findings indicate that minimally trained/experienced paraprofessional counsellors can be as effective as professionally trained and experienced counsellors. More research into the effectiveness of paraprofessionals with specific client populations is required to determine the conditions under which they can be most effective. Aims: To evaluate the effectiveness of a group of 12 minimally trained/experienced volunteer mental health counsellors. Method: Data were collected over a one year period on 118 clients referred to a voluntary sector counselling agency. The CORE-OM was used to measure clients' levels of distress on a session-by-session basis. Clients and counsellors also completed a range of additional self-report measures. A benchmarking strategy was used to evaluate the outcomes achieved by participants in this study against three benchmark studies selected from published literature. Results: Paraprofessionals in this study were less effective than their professional counterparts. Results showed that participants in this study achieved an effect size of .70 compared to effect sizes of 1.36, 1.39 and 1.42 in the selected benchmark studies. Implications: Findings suggest that minimally trained/experienced paraprofessional counsellors working in mental health settings may benefit from longer and more targeted training programmes before engaging in practice. Conclusions: The benchmarking strategy provided a valuable and practical means of evaluating the comparative effectiveness of paraprofessional and professional counsellors. Findings should be interpreted cautiously as the selected benchmarks are not precise measurements and may not reflect the organisational factors operating within voluntary sector counselling agencies.     

Training and Research in Counselling

Formal counselling training in Britain began with the preparation of school counsellors in universities and relied largely upon American models. Early courses were highly didactic but over the last decade practical and experiential aspects have taken precedence. Basic counselling training has now been extended into the preparation of many workers, voluntary and professional. Counselling research also had academic origins, but has broadened to include many different work settings. Much of the published research has been in the form of surveys of counselling services, but some detailed studies of process are noted. There is a need for research to be increased, and the gap between research and practice shortened, if counselling is to demonstrate its relevance to contemporary needs.     

The experience of working with refugees: counsellors in primary care

The provision of counselling services for refugee and asylum-seeking patients is relatively new in the UK and their complex needs may present considerable challenges within primary care, where access to specialist support resources is often limited. As far as we know, no previous research has attempted to look at the experiences of the counsellors who do this work. We undertook in-depth interviews with 13 counsellors who provide counselling to refugees in primary care in north London. The findings of this study suggest that counsellors who work in a primary care setting find themselves conflicted, troubled and out of their depth by the experiences, narratives and distress presented by refugee and asylum-seeking patients. They also report an erosion of usual counselling boundaries. Thus, the problems presented by refugees seem to demand approaches which go beyond standard counselling practice and which create ambivalence and uncertainty. These counsellors express feelings of isolation and impotence. The paper concludes with implications for counselling practice and suggestions for further research.     

Marriage Counsellors’ Reflections on the Counselling Process in Family Courts in India

Family courts in India were established to facilitate speedy redressal of family disputes, particularly matrimonial issues. Marriage counsellors facilitated dispute resolution based on alternative dispute resolution practices. Counselling was mandated for all couples approaching family courts due to marital discord. At present, there is a lack of literature on the process of counselling followed by marriage counsellors in the family courts. The present study used an exploratory research design to understand marriage counsellors’ perspectives on the process of counselling in family courts. Fifty-six marriage counsellors completed open-ended questionnaires on counselling assessment, goals, interventions and the influence of the presence of children on the couple counselling process. Thematic text analysis of the responses revealed a range of areas that counsellors explored, individual and relational goals that they focused on, as well as the interventions used by marriage counsellors in their work with couples. Findings suggested that there was a lack of uniformity in the counselling approaches used by marriage counsellors. Additionally, marriage counsellors reported not being equipped to address some intrapersonal and interpersonal concerns that emerged in the counselling process, despite identifying them. Based on the findings, the paper recommends the need for a unifying framework for training and practice for marriage counsellors working with couples in family courts to conceptualise couples’ concerns as well as guide their goals and interventions. The paper underscores the need for acknowledging sociocultural influences, reflective practice and client feedback in the process of counselling.     

Explorations of the effectiveness of a voluntary sector psychodynamic counselling service

This paper reports two studies of individual psychodynamic counselling provided by a voluntary sector service. The first study examines evidence of the effectiveness of counselling, as evaluated by the General Health Questionnaire and Personal Opinion Survey. Measures of the process of counselling indicated the improvements that clients attributed to counselling, the changes that occurred during it, and the factors that were most beneficial, as well as the approaches used by counsellors. The second study, using the CORE Outcome Measure and ratings of problem severity, found counselling to be equally effective with disadvantaged and non‐disadvantaged clients, as defined by British Department of Health criteria, but these clients differed somewhat in their perceptions of helpful aspects of counselling. Both studies also indicated predictors of positive outcome of counselling. The studies are used to illustrate some of the methodological issues around research in this area.     

Transcultural Counselling and Psychotherapy in the 1990s

Transcultural counselling has its origins in practice rather than theory. There still remains a unified method to develop, and extensive epidemiological and clinical research to carry out, The growing body of work in the field of mental illness and racism, however, has encouraged clinical counsellors in the UK to describe, prescribe, develop and publish their work much more widely. Some recent developments are outlined against the background of political and social changes in Britain in the nineties. Implications for research, training and service delivery are examined.     

Student counsellors’ experiences of mindfulness as a component of their person-centred counselling training: An interpretative phenomenological analysis

Aim

Mindfulness is increasingly integrated into counselling and psychotherapy practices, as well as being introduced to students in academic institutes with the aim of supporting them to balance the responsibilities of academic study, placements and other commitments alongside university life. Despite mindfulness routinely finding its way into counselling settings and being incorporated into counsellor training, there has yet to be any research conducted to explore the experience of student counsellors who have received mindfulness as a part of their undergraduate person-centred training. This study explored the reflections of counsellors who had attended a mindfulness module during the first year of a counselling degree.

Design

Six students completing a university-based undergraduate degree in Counselling and Psychotherapy in the North-West of England, in the UK, participated in the research. The study consisted of two students from each of the three years of the programme. Participants individually attended a semi-structured interview to explore their experiences of mindfulness as a mandatory module of their training in person-centred counselling. Interpretative phenomenological analysis (IPA) was used to analyse the generated data.

Findings

Four superordinate themes were generated: 1) becoming a counsellor, 2) person-centred mindfulness, 3) time, and 4) learning and development.

Discussion

Experiential themes were explored including the process of professionalism, vulnerability, embodiment of person-centred theory and the core conditions and the conflict of approach.

Conclusion

Recommendations are made for mindfulness to be included in counselling training programmes with a person-centred focus. Suggestions for further research include longitudinal studies to follow the development of trainees over time.     

Counselling in areas of armed conflict: the case of Jaffna, Sri Lanka

In this article counselling is discussed in relation to the traditional resources of the Tamil community for dealing with psycho-social and mental health problems. It describes some of the problems of clients affected by the armed conflict, the approaches of the local counsellors and mental health professionals, and the training offered to future Sri Lankan counsellors who want to work with people affected by the armed conflict on the island.     

Making a difference for young people with learning disabilities: A model for inclusive counselling practice

The prevalence of mental health problems in young people with learning disabilities and the disability rights movement provide the background to this paper. The aims are to investigate the inclusivity of counselling; gain insight into inclusive practices; and put forward a model for inclusive counselling practice. Mixed methodology provides quantitative and qualitative data through a survey of counsellors (n = 396) and a series of semi‐structured interviews (n = 15). The results produce six indicators of inclusive counselling, which are used to build a model for inclusive counselling practice: proactive approach to inclusion; focus on building relationships; operationalising equal opportunities policies; inclusive initial assessments; adopting flexible and creative approaches to counselling; and training and awareness raising. The implications for research and practice are to acknowledge the exclusive nature of the profession and address the issue of inclusion through training, professional development and further research in the field. The model for inclusive counselling practice is put forward as a tool for auditing existing counselling provision and as guidance for counsellors and policy makers in increasing inclustion of young people with learning disabilities in mainstream counselling.     

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.     

Hypnosis as a counselling tool

The history of hypnosis is outlined, with particular reference to recent developments. The main current theories are expounded briefly, and applications in short-term therapy and counselling are discussed As therapists from a wide range of systems of psychotherapy and analysis are increasingly incorporating hypnosis into their practice, the hope is expressed that counsellors will take more advantage of training opportunities and extend the use of hypnosis in their own work.     

Voluntary sector counselling: Has inadequate research resulted in a misunderstood and underutilised resource?

Although much counselling already takes place in the voluntary sector, little is known about the nature of the work being done or about its effectiveness or the training and experience of its practitioners. Given the gap between the demand for and supply of psychological therapies in Britain today, lack of research into the effectiveness of this work could mean that a valuable resource is being under‐utilised. This paper describes a study of a large, generic counselling centre and, using the CORE monitoring and evaluation system, makes comparisons between its work and that of a number of NHS psychological therapy services. It shows; that it is of at least as complex or severe a nature; and that it is as effective. It also shows that the therapy carried out in this agency is done by appropriately qualified and experienced practitioners.     

Counselling young people: Counsellors' perspectives on ‘what works’ – An exploratory study

Aim: Counsellors who work with young people in a range of contexts know that they are not engaging with ‘mini‐adults’. The issues young people bring to counselling are often complex, challenging and wide‐ranging, as adolescents are experiencing times of turbulence and change in their physical, emotional, social and psychological development. This paper focuses on a research project undertaken with five counsellors who work with young people, and asks the question: ‘What works?’ Method: The research project is an in‐depth qualitative study into the counsellor's experience of counselling young people, using a narrative approach. Findings: Four key shared themes emerged: the significance of ‘safety’ in the relationship; building the therapeutic alliance; flexibility and integration relating to theoretical orientation; and the use of creativity. Outcomes: This paper offers counsellors the opportunity to reflect on ‘what works’ and consider the professional knowledge, which underpins their own counselling practice with young people.     

Spiritual emergency and counselling: An exploratory study

Growing up in a multicultural community in England brought me into close personal contact with the beliefs and perceptions about healing held by people of many different cultures. In many cases, no strong boundary was seen between physical, psychological and spiritual aspects of an illness, and experiences of hearing voices or seeing visions were accepted as normal everyday occurrences. During my training as a counsellor, I came into contact with the work of Stanislav Grof on the concept of spiritual emergency, which, together with the work of African and European authors who were exploring transpersonal aspects of psychology, provided a theoretical framework for researching how counsellors respond to clients wishing to explore experiences of spiritual crisis. This paper describes an exploratory study into the phenomenon of spiritual emergency within counselling. Questionnaires were distributed by post to people known to have been in counselling relationships, and interviews were conducted with three informants reporting different types of spiritual experience. All respondents who completed questionnaires reported having at least one of the ‘non‐ordinary’ experiences classified by Stanislav Grof as characteristics of a ‘spiritual emergency’. Several participants felt unable to explore this experience with their counsellors, some for fear of being labelled as mentally ill, while others found their counsellors helpful and sympathetic. Differences in dealing with spiritual phenomena were apparent between European and non‐European participants. These findings are discussed in relation to theory and practice.     

Subsequent careers of teachers trained as counsellors

This survey report is divided into six sections. First there is a detailed analysis of data concerning those who work as counsellors within schools. The second section compares this counsellor data with that obtained from a sample of students on full-time courses. Section three indicates the senior positions which counsellor-trained people have achieved in schools, while the next section looks at those employed in other non-counselling positions within the school. The fifth section indicates the various routes of possible mobility outside the school milieu which are open to trained counsellors. Section six deals briefly with a group of teachers interested in counselling who have not undergone full-time counsellor training. Finally, various questions raised by the study are posed.     

Family therapy ‘lite’? How family counsellors conceptualise their primary care family work

A number of current developments in the field potentially provide opportunities for preventative relationship and family interventions to be integrated into primary care. In this context, it is important to understand what family counselling is and how it might differ from family therapy. Thus, this paper investigates how the service of one low-intensity family counselling provider, Relate, is conceptualised and practised by counsellors on the ground. Questions about practice were posed to five focus groups of family counsellors and these were analysed using thematic analysis. The findings suggest that Relate family counselling is seen as ‘family therapy lite’, with a flexible, eclectic and integrative use of concepts and techniques within a systemic framework. Implications of this conceptualisation of family counselling for training, practice and research are discussed.     

Moving beyond counselling and psychotherapy as it currently is – taking therapy outside

Research was undertaken by the author in order to describe, interpret and explain what happens when counsellors and psychotherapists who have been trained to work indoors with their therapy clients take their therapy practice into outdoor natural spaces. A central research question addressed ‘What happens when counsellors and psychotherapists, who have been trained to work indoors with their therapy clients, take their therapy practice in to outdoor natural spaces?’ Semi-structured interviews were undertaken with therapists who practised outdoors. Three dominant themes emerged critiquing aspects of current counselling and psychotherapy practice. These were related to the unfolding ecological crisis, the context of the work and moving beyond current conceptions of distress and the role of therapy in addressing this.