‘The third person in the room’: Recording the counselling interview for the purpose of counsellor training – barrier to relationship building or effective tool for professional development?

Objective: Audio and videotape interview recording for training and supervision in counsellor education is commonplace within New Zealand, yet researchers have paid little attention to its value perceived by students. This study explores counselling students’ perceptions of the effects of recording counselling interviews on themselves, their clients and on the counselling process. Design: Counselling students from five tertiary educational settings in New Zealand participated in individual or focus group interviews to discuss their experiences of recording counselling interviews. Findings: All interviewees indicated that recording initially curtailed their ability to be completely present in the counselling interview. Some thought this may have negatively influenced their clients’ ability to use the counselling session effectively. Most noted their own increased confidence over time. Almost all considered recording to be extremely beneficial to the development of effective counselling skills. Conclusion: Most students considered the benefits of recording to outweigh the drawbacks. Implications for continuing the practice of recording and playing back interviews in counsellor‐education programmes are considered.     

The effectiveness of UK student counselling services: an analysis using the CORE System

Despite concern surrounding the mental health of students, brought about by the government's policy of widening participation and increasing demands upon students, the effectiveness of student counselling has been a neglected research area. This study examines data from seven UK student counselling services using the CORE System in the routine evaluation of their services. Results indicate that counselling is effective, with 70% (service range 67% to 83%) of clients with outcome measures available showing reliable improvement on the CORE-OM from pre- to post-therapy. However, students who complete a course of counselling show significantly greater improvement, according to practitioner pre- and post-therapy severity ratings of depression and anxiety, than those clients who drop out or have an unplanned therapy ending (effect size 1.03, 0.85, respectively). The stage at which students drop out of therapy is important, with those students dropping out of therapy before the third session being the most vulnerable. The implications of these findings are discussed.     

A study of Muslim Asian women's experiences of counselling and the necessity for a racially similar counsellor

A survey of four Muslim Asian women of varying ages was carried out, for whom the author had previously acted as a counsellor. The survey was designed to explore the extent to which client and counsellor racial similarity affected the therapeutic alliance, as the counsellor/author was of a similar race to all four clients. It was the author's belief that racial similarity in itself would not procure positive counselling outcomes, and hence this study attempted to explore the clients' perceptions of qualities extrinsic to race, including interpersonal skills, styles and approach to counselling of the counsellor, in order to duduce whether in fact these factors were more singnificant to the outcomes than race. The majority of clients did not feel racial similarity was an essential quality, although one client expressed cultural awareness as being a preferable quality. This has suggested that it is not essential for client and counsellor to be racially similar in order to achieve successul counselling outcomes.     

Perceptions of counsellor effectiveness: A study of two country groups

The perceptions of United States' (US) and Singaporean college students on directive and nondirective counselling approaches were examined. A total of 103 Singaporean students, studying in Canada and the US, and 108 US students participated in the study. Simulated counselling interviews of the two approaches were presented to students through videotapes. After watching the counselling sessions, students rated the counsellor with the Counsellor Effectiveness Rating Scale; they also were asked to write comments about the counselling session. A multivariate analysis yielded a two-way interaction effect by country of origin. Counsellor expertise was rated significantly higher by Singaporean students observing the nondirective style, while US students rated the directive style higher. Qualitative responses from students were also examined. Implications are discussed.     

Transference with the borderline client

This paper addresses the question of what is involved in psychodynamic counselling with borderline clients. The concept of borderline functioning or structure is explained and the technical difficulties of working in this area noted, especially in the establishment of a working alliance. The types of transference manifestations with borderline clients are then described, looking in particular at the emergence of a psychotic transference. Two case examples are given of working with borderline clients, where the transference was dominated by primitive elements, provoking powerful countertransference reactions in the counsellor. How both the client and the counsellor can be contained in the therapeutic work is then addressed. Finally, some implications of this discussion are drawn out for the training of psychodynamic counsellors, in order to equip them best for working with borderline clients. Three features of what a training should offer are identified: it should provide students with the opportunity for the exploration of the psychotic parts of their own personality; it should allow for and encourage the internalization of psychoanalysis itself as a sustaining internal object; and it should provide students with the experience of working with clients over sufficient time and at sufficient depth so they can learn about the timing and effectiveness of interventions in work with borderline clients.     

Psychological Test Interpretation: Integrative or Disintegrate?

The need for constructive debate by psychologists about the interpretation of psychological tests is noted. This paper is a critique of Crites' integrative test interpretation approach which eschews a specific test-interpretation session in favour of feeding in such data as are perceived appropriate by the counsellor during subsequent counselling. Five problem areas are noted: hidden knowledge; counsellor as guru; clients' rights and responsibilities; using any information in counselling; and little supportive evidence. It is concluded that the 'integrative' approach fails to live up to its laudable intentions. To promote the debate about psychological test interpretation, seven general principles are outlined to further the development of more useful approaches to the use of tests in counselling.     

Avatar‐based counselling for young people within school counselling. Qualitative analysis of client experience

Background

This study is a qualitative analysis of clients’ experiences of a new avatar based counselling intervention, based on the ‘ProReal’ software ( www.proreal.world ). The intervention was piloted in eight secondary schools in the UK in 2016.

Aims

Twenty‐nine participants (53% of the full sample) were interviewed about their use of the software, experience of the intervention, process of change and views about its helpfulness.

Materials and Methods

Interviews were semi‐structured and were analysed using thematic analysis.

Results

The analysis shows that the intervention was potentially attractive to these clients, particularly those enthusiastic about digital software and clients who found visual communication helpful. The software provided additional opportunities for clients to communicate their inner worlds to the counsellor and supported the development of insight. Male clients, in particular, commented on its helpfulness.

Discussion

There is an indication that digital imagery supported the process of change in counselling and the development of meaning bridges: both internally and with the counsellor (Stiles, 2011; Stiles et al., 1990). However, the software could be experienced as an obstacle when clients wanted to talk about specific problems or ‘vent’ their feelings. All clients who reported that they did not find the software helpful were female. There were a number of suggestions about developing the software to increase opportunities for expression as well as appropriateness for clients from different minority ethnic backgrounds.

Conclusion

Use of digital software in counselling has a potential to enhance communication and support a process of change, particularly with male clients, those who find visual communication helpful, and clients enthusiastic about digital technology. Further research is needed to develop the intervention and compare it to the use of other creative media in counselling.     

Responses to Marriage Counselling

The experiences of clients who received marital counselling from trained volunteer marriage guidance counsellors were investigated. Fifty-one clients from 42 marriages were interviewed and questioned about why they chose the agency, what expectations they held, what happened during counselling, how they felt about the counsellor, and what if anything was achieved through counselling. They were also asked how they had fared since. Rating scales were used after the interview to evaluate satisfaction with counselling, benefit from counselling, aspects of the counselling relationship, etc. The clients were also asked to do a card-sort of statements about counselling to determine what aspects had been valuable and disappointing. Some of the preliminary results of the study are presented and discussed.     

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.     

How do you see me? Coming out in counselling

Recent large-scale survey research has raised serious concerns in both the counselling community and the mass media about the ways in which counsellors work with lesbian, gay and bisexual (LGB) clients. The current questionnaire-based research focused on client experiences of their own, and their counsellor's, self-disclosures of sexuality. Most clients did not require counsellor disclosure. However, failure of the counsellor to disclose could result in problems and assumptions being made by the client. We conclude that LGB awareness is improving, but there is still much need for training in this area to challenge limiting assumptions by some counsellors and to avoid the need for clients to educate them.     

Clients talk about their experience of the process of counselling

The purpose of this study was to ascertain clients’ experiences of their counselling. This was done through use of a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in agency located in a mid-sized city in New Zealand. Several themes were identified and discussed in relation to the literature on clients’ perceptions of their own counselling. Specifically, clients were asked to comment on whether their counselling was effective, how much of their improvement was due to counselling versus other factors, the quality of the relationship with their counsellor, specific in-counselling events that were helpful or unhelpful, and how their counselling was terminated. Implications for practice were suggested.     

Marriage guidance counselling: I. What clients think will help

Thirty-one first-time attenders for marriage guidance counselling were given a non-schedule standardised interview and a client questionnaire. The main aim was to identify the counselling and counsellor characteristics which clients considered would be most helpful in dealing with their problems. Traditional counselling skills such as the ability to be warm, supportive, understanding and a good listener were seen to be important by most clients. However, the vast majority of clients indicated that it would be helpful to receive the counsellor's opinion about their marriage, their personal problems and marriage in general: this is incompatible with a non-directive approach to counselling. Whilst clients may not know best how they should be helped, counsellors who fail to address their preconceptions risk mutual disappointment and premature termination of counselling.     

Ideas of influence: counsellors' talk about influencing clients

The influence the counsellor has on his or her clients is problematic both theoretically and practically. This article explores how counsellors in six focus groups talked about counsellor influence in response to a series of scenarios and questions. The counsellors adopted three main, or 'core', positions about influence: 'counsellors shouldn't influence'; 'influence is inevitable'; and 'counselling is influence'. These were linked by various 'bridging arguments' through which the research participants made sense of the contradictions between the core positions. The rhetorical use of these bridging arguments highlights some significant paradoxes within counselling around power, influence and direction.     

Transformation in Counselling

The view is put forward that counselling appears to be undergoing a transformation which renders the old distinction between counselling and therapy no longer meaningful or practical. This transformation reflects the psychic backdrop of our times; it has come about because the needs of people seeking help, as well as the needs of those counselling, have altered and developed. Increasingly, clients are acknowledging the need for radical change which involves exploration of all levels of their being. This transformative work, a moving across inner barriers and coming into wholeness, necessarily involves active awareness of spirit. Thus it is no longer possible to be a client-centred counsellor without being willing to address the spiritual dimension ofhuman-beingness.     

The Practice of Counselling HIV/AIDS Clients

AIDS/HIV has been described as one of the most pressing medical and social problems of this century. A review of the psychosocial and counselling literature relating to it indicates that the predominant psychotherapeutic approach with clients is symptom-focused and presents psychological problems as being inevitable in the course of illness. A systems approach is considered to have a good fit' with HIV-related problems because of issues relating to unpredictability, relationships, interaction, complexity and secrecy which arise in the course of the illness and its management. Some of the counselling tasks of an AIDS counsellor are set out. Consideration of these can help the system (client, family, health care team, counsellor) both to define problems and to find solutions to them without resorting to prior assumptions about either.     

Client attendance measures in counselling psychology trainees

Counselling supervisors and educators have yet to reach a consensus about standard measures for evaluating the performance of graduate student therapists. Compared to self‐reports and rater judgements, client attendance records provide low‐inference behavioural data partially reflective of clients’ engagement with therapists. This naturalistic study evaluates client attendance data using archival records of 92 doctoral students in beginning and advanced counselling practica who produced data for 771 clients, 3,949 scheduled sessions and 3,186 attended sessions. Providing evidence of the sample representativeness for clinicians, results indicated that the mean number of sessions attended per client for student therapists (5.65) was very similar to that reported in the literature for outpatient therapists (<6). As expected because of structural differences in client assignment, beginning and advanced students evidenced statistically significant differences on attendance variables such as number of clients and scheduled sessions. In contrast, attendance ratios were equivalent across counsellor experience, suggesting that these individual difference variables could be useful for evaluation of therapist competencies related to client engagement.     

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.     

Experiencing gay affirmative therapy: An exploration of clients' views of what is helpful

Gay affirmative therapy is a counselling approach that emphasises an affirming, non‐pathologising approach to therapeutic work with lesbian, gay and bisexual clients. In this study, lesbian and gay clients who had experienced counselling that they defined as affirming identified what they perceived to have been helpful. Questionnaires and interviews were used to collect the views of a sample of lesbian, gay and bisexual informants. The material gathered was analysed using a grounded theory approach, which generated six main categories: communicating a non‐pathologising perspective on homosexuality; the counselling relationship; the counselling space; what the counsellor brought to the relationship; humanity; and the counsellor adopting a holistic approach. Some of these identified affirming elements are unique to gay affirmative therapy and cannot be attributed to other factors. The possible significance of the findings for practitioners is discussed.     

Gliding across the liminal space between counsellor and counselling researcher: Using collective biography practices in the teaching of counselling research methodologies

Aims: Drawing on their engagement in a specific collective biography research project, the co-authors aim to demonstrate how the weaving together of creative story-telling and the theory underlining collective biography practices resulted in an understanding of rhizomatic research methodologies from within the process. This paper aims to demonstrate one way in which research methodologies training can become more firmly embedded within counsellor training courses. Method: A collective of counselling students and a session tutor colleague used collective biography practices to research their memories of traversing the liminal space between ‘counsellor’ and ‘counselling researcher’. Alongside the resulting collective stories, a collaborative review of the research process examined our chosen ways of working within the project. Outcomes: Engaging in collective biography practices resulted in an experiential shift from ‘learning to do counselling research’ to ‘becoming counselling researchers’. Weaving together research processes and researcher reflexivity generated personal and professional learning. Ways in which these research methodologies complement core components of counselling training, within and beyond the teaching of research, were identified. Conclusions: Collective biography practices offer a way of introducing non-arboreal creative research methodologies into counsellor training. Careful consideration of potential challenges surrounding the introduction of these practices is required.