Exploration of the attitudes of employees towards the provision of counselling within a profit‐making organisation

The provision of workplace counselling has risen significantly over the last 20 years in response to the increase in stress‐related illness amongst employees in UK profit‐making organisations. Despite this expansion there is very little exploration of employee attitudes towards this provision. This paper describes a case study of employee attitudes towards counselling in a UK profit‐making organisation utilising an Employee Assistant Programme (EAP) for staff counselling. The method used for the research was a quantitative approach administered using a short questionnaire distributed to employees by e‐mail. The responses to the questionnaire illustrated that most employees were highly aware of the service and believed stress to be the highest presenting issue to the EAP counsellors. However, stress was actually the lowest presenting issue. The results from this study also suggested that managers had a more negative attitude towards counselling than non‐managers. Men and women were found to have the same highly positive attitude towards counselling. Respondents felt that wider, constant and regular positive promotion of counselling, by the employer as well as the EAP, was needed to increase utilisation of the EAP counselling service. Concerns over confidentiality for those using, or contemplating using, the service were also found — as in other studies — but this study found concerns particularly in relation to managers finding out that an employee had attended counselling. The implications of these findings are discussed.     

Counselling in primary care and the new NHS

A detailed overview of the changes in the structures of the new NHS in England, Scotland and Wales is presented, looking at the effect these changes will have on counsellors working in primary care. New structures for the provision of counselling in primary care and their implementation are explored. Supervision of counsellors in primary care is addressed and how supervision might fit into a managed counselling service. The requirements of clinical governance are discussed, as is the necessity of appropriate audit and evaluation data to inform service and individual development.     

An appraisal of abortion counselling

Abortion counselling is examined on the basis of 306 cases seen in a pregnancy advisory service. Its aims and process are compared with other forms of counselling; problems of ambivalence, pressure from others, economic reasons and patient fears are discussed. Because of the many clients who presented with these problems and with relationship difficulties, it is suggested that a more broadly-based 'watershed counselling' service be established. Such counselling could provide full information about abortion and its alternative, and could also provide useful aftercare.     

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.     

Young people generating a repertoire of counselling psychology: Talking theory

This paper is concerned with how young people, who are trained as peer supporters in British secondary schools, construct a counselling repertoire. Issues of identity, boundaries and the dilemma of advice giving are all raised when pupils aged 14-17 talk about their roles in peer support. It becomes evident that young people's constructions of themselves and their schemes reflect the assimilation of both traditional psychological theories and contemporary counselling culture. In essence, their scheme may be marketed as a counselling/advising service, which could lead the young people to take on the role of 'counsellors'. On the other hand, their scheme may be promoted as a listening and/or support service and this will lead to young people questioning their role in the scheme. This paper will introduce these issues. This research is taken from an ongoing PhD project which uses language based research as its methodology.     

Training Counsellors to Work with People who Live with Cancer: A Needs-led Approach to Planning

This paper traces the development of a cancer counselling service within a voluntary helping agency. The steps of recognizing the needs of people with cancer, identifying multi-faceted desired outcomes and the implementation of one specific goal, that of provision of a counselling service, are outlined. Significant events, stages and decisions made during this process are described and discussed. The emphasis throughout is on the importance of needs analysis and client group consultation in order that the planned service is best placed to meet such needs.     

The role of counselling in community support for HIV/AIDS in uganda

HIV/AIDS counselling in medical related programmes focuses upon pre- and post-test counselling. The MRC programme in rural Uganda, a high prevalence area, began with pre- and post-test counselling, but as it was a community based programme this was not found to be adequate. As the programme developed, the counselling service became a way of strengthening the community to withstand the effects of HIV/AIDS. The paper describes the de-centralization of the counselling Programme from a medical centre to community centres. To monitor and evaluate the programme a set of quantitative and qualitative indicators were developed, these are introduced and discussed.     

Evaluating an innovative counselling service for children of divorce

An evaluation of the first counselling service in Britain for children of divorce is reported. In a previous article, the quantitative outcomes of counselling were outlined, which included such data as the children's self-esteem and perceptions of divorce. Here the focus is on the qualitative outcomes of the counselling evaluation: namely, the children's and mother's satisfaction with the counselling, and the counsellor's opinion of its success. The conclusions of the study and their implications for practice are discussed.     

Private work in public places: Confidentiality and role tensions in a university counselling service

This paper aims to explore issues of confidentiality relating to working with undergraduate and postgraduate students in a university counselling service. The context of a counselling service within our institute of higher education has to be understood in its relationship to academic, administrative and managerial staff, to medical and psychiatric services personnel and to the wide range of other student support and welfare services in the organization whether run by university staff or the students' union. Some reflection will be given to the need for clarity in the range of roles counsellors have to play within the different functions of the university. The client-counselling relationship cannot be seen as a dyad but as a triad or an even more complex constellation of relationships when regarded in an institutional context. The central premise is based on understanding the conscious and unconscious dynamics in the institution and how these impinge on the relationship between client and counsellor in challenging or assuming the confidentiality held by the service. Such boundary issues are identified in consultation and referral, breaking confidentiality, referral of disruptive students, calls for help and holding confidentiality. The case material drawn on to illustrate these five areas is also described in terms of anxieties raised and how these are projected, introjected and contained.

Within the service client and counsellor contract to work together. It is made clear that counselling is a professional relationship with agreed boundaries and a commitment to confidentiality. This is crucial to the working relationship and is a means of providing the client with both safety and privacy. Any limitation on the degree of confidentiality offered may reduce the usefulness of counselling. Bound by his or her professional code of ethics the counsellor will reach an agreement with the client at the outset about the extent of confidentiality they are offering, take care not to disclose information given in confidence and, when possible, be able to negotiate any change in agreement with the client.

Exceptional circumstances which may occur and give rise to the counsellor's decision to break the confidentiality formerly agreed between him or herself and the client are those which give grounds for believing the client will cause serious harm to others or themselves or have harm caused to them. Reference will be made to the role of consultant supervision in such situations and how any breaking of confidentiality can best be minimized. Attention will be given to the relevant ethical codes to which counsellors adhere and the issues of confidentiality within the legal process as well as whether the requirements of providing counselling services for students in higher education impel us, logically and practically, towards certain policies in regard to boundaries.     

Challenges to addressing student mental health in embedded counselling services: a survey of UK higher and further education institutions

With reports continually demonstrating increased demand and severity of student mental health needs, it is important to gain a fuller understanding of the impact on embedded student counselling services. The aims of this research were to identify (a) service similarities, (b) factors which impact on services, (c) characteristics of service users, and (d) the use of therapeutic technology (e.g. online self-help). An online survey was completed by 113 heads of UK student counselling services across Higher Education (HE), Further Education (FE), and Sixth Form Colleges (SFCs), to capture service data from the academic year 2013/14. Students predominantly received high-intensity support (e.g. counselling) and referrals increased over 3 years. Challenges to embedded counselling services and their implications for development are discussed.     

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.     

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.     

The participation of children and adolescents in family counselling: The German experience

This paper reflects the experiences of young people in child guidance and family counselling. For this purpose, first the institutional background of these counselling services in Germany is outlined. The fact that the adolescents concerned feel partly excluded and insufficiently integrated into the counselling process is illustrated through qualitative analysis of the experiences 17 young people had during their counselling process. These empirical findings are critically discussed in terms of the institutional conditions and methodical approaches which counteract the involvement of the actual addressees of the counselling service. The paper concludes that professionals need to attend more to facilitating the participation of young people.     

Some problems of genetic counseling in schizophrenic psychoses

The authors sum up the most important basic principles of diagnostics and genetics of the schizophrenic psychoses from the viewpoint of genetic counseling for the practising psychiatrist and medical geneticist. Regarding genetic counselling strategy, in addition to nosological considerations, they stress the importance of socio-cultural and social psychological factors and of the emotional atmosphere in the family, which should all be taken into account together. Because of the special situation of schizophrenic (and in general, psychiatric) patients and their families, they regard it as advisable to set up a separate psychiatric genetic counselling service.     

An investigation into the client at the heart of therapy

This paper reports on an exploration of the experience of the client at the heart of therapy. A grounded theory analysis of clients' experiences of therapy provided through a voluntary sector counselling service was undertaken, and generated four main categories: permission, engagement, transparency and restructuring. The results of the study are presented in a way that hopefully retains much of the richness of what people have reported about their experience of counselling. The findings of the study are discussed in terms of the idea that counselling can provide a setting where people can have common therapeutic requirements met.     

The role of the regular teacher in a whole school approach to guidance counselling in Ireland

A whole school approach to guidance counselling has been promulgated by Irish policy-makers as a model of good practice in the delivery of guidance counselling in the post-primary sector since the 1998 Education Act (DES, 2005a, 2009, 2012). This approach to guidance counselling provision is viewed as a whole school responsibility where schools are expected to collaboratively develop a school guidance plan to support the needs of their students. The role of the regular teacher in a whole school approach to guidance counselling has received very little attention either in the Irish education system or in empirical research. This article will address this deficit through its discussion of a case study carried out in one school in 2012. It will position the findings from the study in the context of the re-allocation of post-primary guidance counselling provision in the national Budget 2012 that has witnessed the substantive erosion of the guidance counselling service in the last two years.     

Counselling in primary care: past, present and future

The rapid growth of counselling in primary care has happened unofficially and almost by stealth over recent years until it has established a niche within many primary health care teams. If it is to survive following the latest reform of the NHS, it has some serious challenges to face. These challenges are to the very nature of counselling and involve the need to establish the professional identity of the counsellor in primary care. The current bias towards the regulation of health professionals also impinges upon counsellors in this domain, along with the need for their effective management and harmonisation of services within the health service. Evidence for the effectiveness of counselling is a pressing concern in a realm where the random control trial has reigned supreme. Whether or not counselling in primary care is subsumed into other health care professionals' roles is a matter for much speculation. Perhaps counselling will become 'medicalised' or perhaps it will develop further and continue to offer a different perspective on health and healing and remain in place to further enrich the services offered in primary care.     

Psychoanalytic psychotherapy and student counselling

This paper explores the experience of a psychotherapist working in a university counselling service, indicating the contribution I think a psychoanalytic orientation can make to this kind of work. The exposed ‘coal face’ nature of the work is illustrated, and some of the psychotherapeutic implications of working within a large organisation discussed. There is an exploration of institutional dynamics which bear directly upon the psychotherapist, in terms of what it is possible to provide, and of professional self-preservation and self-esteem. Analysis of the uses made of the counselling service is seen as a contribution towards enabling the service to represent properly itself and its concerns within the institution.     

Counselling and the schizophrenias

Schizophrenia is the collective name given to allied psychiatric disorders each of which has received a number of different professional interpretations. A primary counselling task is to help staff resolve conflicts over treatment, and give them support during their care of patients. Counselling patients and families, particularly through opportunities provided by self-help groups, is also discussed. The specialised work of genetic, psychoanalytical and behavioural counselling is considered, and stress is laid on the importance of counselling the adolescent schizophrenic for whom early help is vital to prevent deterioration. The article focuses on those areas where marriage guidance counsellors, social workers and probation officers are most likely to be consulted.