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.     

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.     

Young clients' narratives of the purpose and outcome of counselling

This study explores how adolescent clients construct the purpose and outcome of counselling. A narrative analysis was performed on interviews with 22 clients (aged 16–18) who had used a school-based counselling service. The aim was to identify the purpose and outcomes that participants attributed to their counselling experience. The analysis identified four narrative forms that young clients used to describe counselling. These included ‘transformative’, ‘supportive’, ‘pragmatic’ and ‘disappointed’ narratives. Each narrative form constructed a different purpose and outcome for counselling. Engaging with clients' narratives about the purpose and intended outcome of counselling may allow counsellors to better match their expectations and approach to fit with their young client or to work with them to co-construct more flexible narratives that support helpful outcomes.     

Physicians’ views on men's mental health and the role of counselling services – a pilot study

This pilot study aimed to explore how physicians understand men's avoidance of mental health counselling services and to elicit physicians’ views on pairing mental health assessment with routine physical examination. Initially, physicians’ views on men's avoidance of mental health counselling services were explored through a focus group. A short survey exploring views on pairing mental health assessment with a routine physical examination was then developed and sent to 125 physicians at a local medical centre. Physicians discussions indicated that male socialisation processes, the stigma of needing help, and ignorance about counselling sessions, all contribute to men's avoidance of mental health counselling services. The survey results suggest that combining a mental health assessment with an annual physical examination was viewed positively by most physicians (80%), that they would encourage this approach (75%), and would appreciate the support of counselling services in this process (80%). However, these survey results were influenced by the age and sex of the physician. The focus group suggestion to pair mental health assessments with routine medical examinations, with support from counselling services, was viewed by most physicians as a positive way to engage men. Preliminary services could be established that utilise this approach and examine its efficacy.     

Accessing the multitude within: A psychoanalytic perspective on the transformation of masculinity at mid‐life1

This paper reflects upon the essential components of male identity that commonly are reworked in middle age. The author argues that healthy masculine gender identity involves an ongoing, plastic process of destabilization and reconstruction at various pivotal developmental stages, particularly during middle adulthood. In essence, a man's mature transformation of his sense of masculinity results when finite concepts of gender identity are superseded by an awareness of the complexity of one's multiple, early and diverse gender identifications. A clinical case provides insight into how psychoanalytic treatment can contribute to a new experience of masculinity. The case illustrates how a maturing man, meeting an altered sense of identity in mid‐life, relies less on gender splitting and more on reuniting previously antithetical intrapsychic elements. Why this more pluralistic, polythreaded masculinity frequently must wait until mid‐life is further clarified. Specific importance is attached to the early development of male gender identity as it is founded on the boy's unique struggles in separating from his mother. The foundation for male gender identity formation is reconsidered as the author questions the ‘dis‐identification’ model while explicating how the boy's striving for narcissistic completion shapes the gendered masculine ego ideal. Classically termed ‘phallicism’ is understood both to facilitate and obstruct a man's adult development, while the concept of ‘genitality’ is augmented by the postclassical notion of ‘interiority’. At mid‐life, ‘phallic’ ego ideals (resting on omnipotence, desires for narcissistic completion and gender splitting) are transformed into more realistic, ‘genital’ ego ideals (synthesizing autonomy and connection). The achievement of a mature, less sharply gendered ‘masculine’ ego ideal (revitalizing the foreclosed dimensions of both the early maternal and paternal imagos) occurs as the balance of forces shifts in the direction of true genitality rather than defensive phallicism.     

Individual and gender differences in good and first‐class undergraduate degree performance

Corroborating recent findings elsewhere, women within a large undergraduate sample at the University of Sussex achieved a greater proportion of ‘good’ (first‐ or upper‐second‐class) degrees than did their male counterparts. This female advantage disappeared when statistically controlling for the trait openness to experience and for study‐related behaviour whilst at university (i.e. attending seminars and completing ‘non‐contributory’ assignments). Contrary to robust findings previously obtained elsewhere, only slight and unreliable evidence was found that men at Sussex obtained a greater proportion of first‐class degrees than did women. Moreover, differences favouring either gender were unreliable across the subjects of study. Indeed, ‘subject gaps’ often appeared more pronounced than ‘gender gaps’, where present. We conclude that emphasis should be shifted away from research on gender differences per se in favour of recent approaches that more directly explore reasons for successful undergraduate performance. However, to the extent that subject choice is an important determinant of degree performance, gender differences in subject choice will continue to be an important area of research.     

Phenomenological research on supervision: Supervisors reflect on ‘being a supervisor’

A study using a phenomenological research method was performed to reveal the meanings of the concept ‘supervision’, from the supervisor's perspective. Eleven supervisors of counselling and psychotherapy from a humanistic/existential framework answered the open question: “What does being a supervisor mean?”. Content analysis and frequency measuring were performed, revealing six groups of statements; six facets describing the experience of supervision: ‘structuring’, ‘teaching’, ‘nurturing’, the ‘supervisor as person’, ‘supervisor as colleague’, and the ‘triangle, client-therapist-supervisor’. Structuring was the largest category, and the first three categories together represented more than 75% of the statements. The results showed that ‘teaching’ and ‘nurturing’ were very similar in their importance, as represented by the number of statements in each. Further research should address the possible relation between supervisors' perception and experience of their role and the theoretical framework of counselling and psychotherapy in which they are based, The phenomenological research method in this study has shown the possibility of doing research on processes without ‘betraying’ the subjective perspective.     

Making sense of male rape: constructions of gender,sexuality and experience of rape victims

This study reports a preliminary investigation into accounting practices for male rape in conversation. Thirty men and women, in dyads, were asked to discuss an incident of male rape presented to them in a vignette. The findings showed that two main issues were discussed: the experience of the rape act and societal responses to male victims. In addition, participants established a ‘hierarchy of suffering’, where rape was judged to be worse for ‘heterosexual’ men than it is for ‘women’ or ‘gay’ men. Hegemonic, phallocentric representations of heterosexuality were mobilized to argue that acts of rape and consensual intercourse are the same for ‘gay’ men and ‘women’ and therefore less traumatic than for ‘heterosexual’ men. This obscures the violence of rape for gay men and women and exonerates perpetrators by minimizing injury sustained. Participants also argued that heterosexual victims are likely to experience ridicule for having departed from hegemonic masculinity. Arguments were constructed to avoid charges of being dismissive towards women and gay men and of victim blaming in relation to heterosexual men. Copyright © 2004 John Wiley & Sons, Ltd.     

The impact of informant gender on children’s endorsement of scientific and non-scientific information

By roughly 6 years of age, children acquire the stereotype that men are more competent than women in science, technology, engineering, and mathematics (STEM), potentially leading to greater trust in scientific information provided by men. This study tested whether 3- to 8-year-old children differentially endorsed conflicting information about science and toys presented by male and female informants depicted as a ‘man’ and ‘woman’ (Exp1) or ‘scientists’ (Exp2). Children were expected to endorse toy testimony from gender-matched informants; thus, the key question concerned endorsement of science testimony. In Exp1 (N = 149), boys and girls showed a same-gender informant preference for toy testimony; however, girls endorsed the male informant's testimony more for science than for toys – but only when tested by a male experimenter. In Exp2 (N = 264), boys and girls showed a same-gender preference, irrespective of content. Findings suggest that STEM-related gender stereotypes might lead girls to trust scientific information presented by men over women in certain contexts.     

The experiences of therapy from the perspectives of carers of people with dementia: An exploratory study

Design: Interviews were conducted with six carers of people with dementia about their experience of receiving counselling/psychotherapy. Interviews were conducted in the carer's own home, and data were analysed thematically using a narrative approach. Findings: Three themes were identified from the data: ‘Still doing the best I can’ (identified as losses and processes of personal growth); ‘Feeling connected and being understood’ (identified as attributes believed to be important within the therapeutic relationship); and ‘Wanting to share information’ (identified as sharing information with someone ‘neutral’). Carers placed emphasis on the age of the therapist and the amount of therapist self‐disclosure. Attending counselling and/or psychotherapy also helped the carer to find a ‘safe space’ to disclose and share concerns. Discussion: Carer loss and personal growth are explored, together with the importance of building therapeutic relationships and, for the therapist, seeking supervision when managing personal self‐disclosure. The theme of therapist self disclosure is explored together with the importance of therapists seeking supervision when managing personal self‐disclosure.     

Stresses reported by UK trainee counselling psychologists

This study examined stressors and psychological distress in 109 UK counselling psychology trainees. The research focus was two-fold. What is the profile of stressors that counselling psychology trainees report about the components of training? What relationship is there between this profile, and other characteristics of trainees, including their level of current psychological distress? Data from a stress survey and from the General Health Questionnaire were examined. High stress scores were found on three aspects of the stress survey (‘academic’, ‘placements’, ‘personal and professional development’), but not–surprisingly–on the aspect, ‘lack of support systems’. Significant stress differences were reported for gender and age of participants, and highly significant positive relationships were found between General Health Questionnaire and stress scores. Overall, the results suggest actions to be taken. Further research is needed to clarify unavoidable and avoidable stressors in training, and the reduction of trainees’ experience of training stress to the necessary minimum needs to be adopted as an active target by programmes.     

SUICIDALITY IN MEN IN PSYCHODYNAMIC PSYCHOTHERAPY

Based on the evidence of empirical gender differences in attempted suicide and suicide, this paper develops psychodynamic hypotheses on gender‐specific biographic, intra‐psychic and treatment aspects of suicidality among men. ‘Forming Types by Understanding’ is a qualitative method, based on a systematic analysis of similarity and differential reference points to develop ideal types of suicidal men. A random sample of 20 suicidal men who were receiving out‐patient psychodynamic psychotherapy was studied.

Four ideal types of suicidal men were identified: (1) ideal type ‘disconnected’: a predominance of disconnected feelings that is associated with rejection experiences; (2) ideal type ‘hurt’: aggressive conflicts and the realization of disillusioned life reality combined with experiences of real loss and real trauma; (3) ideal type ‘stormy’: an attached‐symbiotic transference offer mobilizes unrealistic wishes to help against a background of unresolved dependency conflicts; and (4) ideal type ‘object dependent’: concrete facts are important in relationships; in case of separation, real repossession of the woman must occur, a lack of emotional experience is compensated. The danger of suicidality, especially in the early stage of psychotherapy, is particularly acute for patients who cannot reach their therapists emotionally and vice versa. Disturbance of the early experience of inseparability from the mother, gender‐specific conflicts in the development of separation and individuation, and failed triangulation are of central psychodynamic importance.     

“If a girl doesn't say ‘no’…”: young men,rape and claims of ‘insufficient knowledge’

Most psychological theories of rape tend to stress factors internal to both rapists and their victims in accounting for the phenomenon. Unlike such theories, social psychological and feminist accounts have drawn attention to social and cultural factors as productive of rape, and have criticized psychological accounts on the grounds that they often serve, paradoxically, to cement pre‐existing ‘common‐sense’. In this paper we examine the ways in which young Australian men draw upon widely culturally shared accounts, or interpretative repertoires, of rape to exculpate rapists. In particular, we discuss the reliance placed on a ‘lay’ version of Tannen's 1992 ‘miscommunication model’ of (acquaintance) rape and detail the use of this account—the claim that rape is a consequence of men's ‘not knowing’—as a device to accomplish exculpation. Implications of our methods for capturing young people's understanding of sexual coercion, rape and consent, and for the design of ‘rape prevention’ programmes, are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

‘Most of Us Guys are Raring to Go Anytime, Anyplace, Anywhere’: Male and Female Sexuality in Cleo and Cosmo

Women’s magazines are a popular site for analysis of socio-cultural messages about gender, sex, and sexuality. We analyzed six consecutive issues of Cosmopolitan and Cleo to identify the ways in which they construct and represent male and female sexuality. Overall, male sexuality was prioritised, ‘real’ heterosex was depicted as penetrative, and orgasm was given precedence. Two main accounts of male and female sexuality were identified. Men’s need for (great) sex positioned men as easily aroused and sexually satisfied, but women as needing to develop ‘great’ sexual skills to keep their men from ‘straying.’ Accounts of pleasure, performance, and the male ego represented men as concerned about women’s pleasure, about their own sexual performance and as sensitive about suggested sexual ‘inadequacies.’ We discuss the implications of these constructions for women’s gendered (sexual) subjectivity, sexual practices, and identities.     

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.     

Therapists' views of the relative benefits and pitfalls of group work and one-to-one counselling for bereavement

Aim: To explore therapists' perceptions of the relative benefits and pitfalls of group work and individual counselling for bereaved clients. Method: Semi-structured interviews with nine experienced bereavement therapists from a range of different contexts generated data which was analysed using grounded theory methodology. Findings: Groups were perceived as having a normalising influence, helping members make new social contacts and practice social skills. Individual counselling was seen as facilitating the initial telling of the story and the expression of extreme emotion. Discussion: The findings suggest that individual counselling may be useful as a primary intervention easing ‘emotional loneliness’ caused by the death of a spouse or attachment figure. Group work may be of more benefit later in the bereavement process, facilitating an engagement with the outside world and alleviating ‘social loneliness’. Implications for practice: This suggests that bereavement services might usefully combine group and individual provision. Initial assessment could help clients clarify their needs and facilitate their choice of service. This would be more cost effective and potentially ease clients' bereavement experience.     

Knowing in the “Executive Way”: Knowing How,Rules, Methods,Principles and Criteria

I advance a variety of intellectualism about knowing‐how that is, paradoxically, suggested by Ryle's positive discussions of that phenomenon. I discuss the roots of the view in Ryle's work, its affinity with John Hyman's (2015) view of factual knowledge, and important points of contrast with Stanley and Williamson's (2001) proposal. Drawing on work by Cath (2015) and Wiggins (2012) I also discuss conditions on knowing practically, in ‘the executive way’, as an alternative to appealing to practical modes of presentation.     

Being in‐between: The relevance of ethnography and auto‐ethnography for psychotherapy research

Aims: This paper proposes that ethnography and auto‐ethnography can make important contributions to counselling and psychotherapy research. Auto‐ethnography is a recent methodological approach that focuses on the subjective experiences of the researcher. It is informed by anthropology, which encourages the researcher to journey alongside the persons being observed and to make meaning of complex symbolic systems in their lives. Method: Examples from a study of therapeutic processes in a mental health setting for women are examined. Discussion: If auto‐ethnography situates the researcher with the insider's perspective and ethnography is from the outsider's perspective, the researcher is caught ‘in‐between’ these two approaches. Acknowledging the concept of ‘in‐between‐ness’ can both cause discomfort and transform the experience of all who engage in the process and enhance the quality of the research.