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.     

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.     

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.     

A model of a psychological service for adults in a formal educational setting

This article describes the development and operation of a psychological service addressing the needs of adults in a formal educational setting. The structure and content of the service differs significantly from that historically available to children or adolescents in Irish schools. The major elements in the service - induction course, workshops, personal growth groups, and individual counselling - are detailed. The present research builds on an earlier investigation by the same authors into the needs of adults in full-time education at Pearse College, Dublin.     

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.     

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.     

The relationship between existential-phenomenological and cognitive-behaviour therapies

The tendency of GPs to cap the number of counselling sessions offered to their patients in primary care has led to an ongoing debate about the effectiveness of time-limited counselling and brief therapy models. the advantages and disadvantages of brief as opposed to open-ended models of counselling in primary care need to be considered from the point of view of the client, the counsellor and the GP. Given that outcome research shows no difference between the two methods, a cost-benefit analysis would indicate that, for the majority of cases, time-limited counselling works very well. But there is still a minority of clients who do need open-ended therapy, and their needs are not being served by the present NHS system. Counsellors should therefore not be debating for either brief or open-ended style in primary care, but should be organizing themselves into expanding the service to give GPs the choice of both approaches.     

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.     

Exploration of counsellors' perceptions of the redesigned service pathways: a qualitative study of a UK university student counselling service

To address the mental health needs of students, UK universities offer bespoke student counselling services. Economic pressures have led services to find innovative ways of redesigning their service pathway. Few studies have investigated staff perceptions of these changes. The aim of this study was to investigate perceptions of staff employed as counsellors at a student counselling service at a UK university that underwent service delivery changes. Face-to-face interviews were conducted with counsellors (n = 5). Framework analysis was used to identify themes and meta-themes. Five meta-themes were identified: the overarching service ethos and service working style; change in the university context; impact of change on working practice; recording and perceived impact on confidentiality; acceptability and effectiveness. Changes to the service resulted in a more efficient service that is perceived to be more acceptable to students. Staff perceptions differed regarding how changes have affected their counselling practice. Despite these differences, the increase in workload was consistently expressed. Tensions remain as staff strive to maintain high standards of service in this changing context. Future research should investigate the process of developing and implementing change as student counselling services strive to evolve sustainable ways of working.     

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.     

Counselling after Stroke: An Unmet Need?

Information was gathered by means of a questionnaire survey and interviews from a group of patients (N = 17) and health professionals (N=13) working within a stroke unit, concerning the emotional needs of patients and and their relatives and how staff responded to these needs. Although most of the staff had received some training or information about counselling and felt that their interactions with patients often involved an element of counselling, there was strong support for separate specialised counselling services to deal with psychological problems suffered by both patients and their relatives. Patients rated assistance with personal and emotional worries and advice about physical problems as equally useful. A strong need for a counselling service in some form or other was expressed by patients. Neither the level of the patients' social support nor the presence or absence of aphasia, however, predicted the strength of interest expressed. It is concluded that specialised psychological help could be useful in various ways for both in- and out-patients and for their families.     

Relateline: An evaluation of a telephone helpline counselling service for marital problems

A year's entries in the log-book of a Relate (Marriage Guidance) Helpline telephone service were examined and analysed. The data recorded there enabled the researchers to collect and evaluate information about the callers, their problems and the responses made by the counsellors. The aims of the service were to offer a prompt response to people whose relationships were in difficulty and were unable to wait for a face-to-face appointment, and to relieve the pressure on the normal counselling service. An assessment of the value of the telephone service is made in the light of these aims. Some of the results are presented and discussed.     

A naturalistic study of the effectiveness of time-limited counselling with low-income clients

The role of counselling and psychotherapy services in relation to the needs of economically disadvantaged individuals has been largely neglected in the recent research literature. Although a small number of theoretical papers and case analyses have been published, there is an absence of studies that examine the effectiveness of counselling with this client group. The present paper reports on a naturalistic outcome study of the effectiveness of time-limited counselling (seven sessions) with low-income clients. Analysis of pre-counselling, postcounselling and follow-up measures of mental health and problem ratings indicated levels of change equivalent to those achieved in controlled studies of counselling and psychotherapy with other client groups. Factors influencing the effectiveness of counselling included gender and employment status. Qualitative client reports suggested that the main benefits experienced by clients were in the areas of self-understanding and self-belief. For illustrative purposes, data from low-income clients are compared with results from employee counselling clients receiving a similar service. The implications of these findings for further research are discussed.     

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.     

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.     

Assessment of HIV counselling and social care services in a London hospital

The use of, and satisfaction with, counselling and social care services was investigated among HIV-infected clients attending HIV specialist climes at Guy's Hospital and Southwark Social Services, London. A survey of 71 clients with HIV infection was carried out using a self-administered questionnaire. The greatest demand was for advice about income support, housing, counselling for the HIV test, counselling for depression or anxiety, psychological support for coping with HIV, help with sleeping problems, mobility allowance, and help with furniture/household appliances. Overall, 57% thought the service was good or excellent; 66% of respondents thought they would use the services in the future. Over nine in ten clients had used the psychosocial support services at some stage since their HIV diagnosis, although only two-thirds anticipated that they would have need of these services in the future. The psychosocial support service will need to remain responsive to the shift in demand for this service, as well as the changing needs of clients who use it.     

A survey of student counselling in higher and further education in the United Kingdom

All higher and further education institutions who reported having a student counselling service were surveyed, using a postal questionnaire, during 1985. Information from 212 institutions is presented. It describes what services exist, how long they have existed, their staffing and their workload (in terms of numbers counselled and type of service offered). Comparisons between universities, polytechnics and colleges of higher and further education are made. The stated objectives of the counselling services are summarised, together with identified priorities in counselling functions. Some of the characteristics of counsellors are outlined, including hours worked, training and qualifications.     

Seelische Gesundheitsvorsorge f��r Kinder krebskranker Eltern

Children of cancer patients are increasingly being paid attention to as target group for family-based mental health prevention concepts in psychosocial oncology. Based on the long-term experiences with the concept Children of Somatically Ill Parents (COSIP) for child-centred medical family counselling, which was developed at the counselling service COSIP at the Hamburg University Medical Centre, a specialized manual was developed for the context of psychosocial care in oncology, which is currently being tested in a multi-center approach. In this article the theoretical framework and the practical steps of this manualized concept in caring for families with a parent having cancer are summarized. Characteristic elements are the flexible handling of the three system levels parents, family and child in the counselling setting as well as focussing on previously defined intervention goals which are expected to strengthen the coping resources in the family and the children. Perspectives for clinical practice and research are discussed.     

A counselling group for adolescents

This paper outlines the aims and objectives of a group for young adolescents set up by two counsellors in an area youth counselling service. It examines the contract made between the counsellors and the group members, the methods used, and some current areas of conflict and potential growth.     

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.