Cognitive counselling intervention: treatment effectiveness in an Italian university centre

Offering counselling to students is increasingly considered as a key academic service. However, the reduction of resources allocated to Italian universities emphasises the need to assess the quality of interventions. This paper presents data reporting the effectiveness of a university counselling service. A sample of 45 undergraduate students completed a cognitive-relational intervention at a counselling service in a University in the North of Italy. The project focused on the development of reappraisal skills and problem-solving strategies to manage difficult situations. The results showed a significant pre and post-intervention reduction in self-reported psychopathological symptoms (measured with Symptoms Check List 90-Revised) as well as in general levels of distress (measured with Clinical Outcome in Routine Evaluation-Outcome Measure). A significant increase in reappraisal levels, measured with the Emotion Regulation Questionnaire, was observed, which is a focal element of the counselling intervention. There were no detectable changes in the level of suppression.     

A cognitive developmental perspective on counselling adolescents

Although developmental perspectives on counselling are increasingly popular, difficulties inherent in these perspectives impede their actual use in practice. In this paper, individual counselling is situated within a cognitive developmental (Piagetian) framework. Its major constructs — structure and function, assimilation and accommodation, and equilibration — can profitably be applied to the counselling of adolescents. The implications of these constructs for use by counsellors are presented in the light of the traditional responsive and initiative conditions required of the helping relationship. Thus, a perspective on actual counselling intervention founded on a major direction in developmental psychology is provided.     

Does teaching a solution-focused model of counselling work? A follow-up of graduates

Objective: To explore the ways in which graduates of a university counsellor-education programme reflected on their career development, retained the programme's distinctive theoretical counselling model in their counselling practice and engaged in continuing professional development. The main aim was to discover whether or not teaching a solution-focused model of counselling was worthwhile. Method: A questionnaire, using primarily solution-focused type questions, was distributed to all graduates. Interest was focused on specific events, both inside and outside the training programme and beyond, that contributed to graduates' sense of development as counsellors. Results: Thirty four graduates (response rate 62%) provided responses indicating their recognition that their sense of competence and identification as professional counsellors develops over time, and is assisted by relevant feedback and supervision from lecturers and practical counselling experience. Graduates also indicated that their favoured working model was solution-focused and that, as a framework, it provided them with opportunities to integrate other counselling models and add complementary professional development education. Conclusion: The graduates' continued use of a solution-focused model supports the view that teaching the solution-focused model is working. The findings are considered alongside four models of counsellor development and implications for counsellor-education programmes are explored.     

Group psychodynamic counselling with final-year undergraduates in clinical psychology: A clinical methodology to reinforce academic identity and psychological well-being

Educational institutions should ensure that students develop a professional identity, as well as safeguarding their well-being and activating awareness and change processes. The aim of this study was to assess the efficacy of group psychodynamic counselling as a means of reinforcing academic identity – considered the forerunner of professional identity – and psychological well-being in a group of final-year undergraduates studying clinical psychology. Thirty-three final-year-students of clinical psychology who participated in six group psychodynamic counselling sessions were compared with sixteen final-year students of clinical psychology who had never participated in an intervention of this kind. The results suggested that group psychodynamic counselling made students feel more capable of managing their lives and more open to new experiences as well as encouraging them to perceive their relationships as more positive and satisfying, to believe that their life is meaningful, and to achieve greater self-acceptance. The in-depth exploration also prompted students to consider their commitment to their choice of career. Group psychodynamic counselling also reinforced students’ educational choice, as the likelihood of students becoming less committed to this choice was reduced after the intervention. Thus, the study confirmed the efficacy of group psychodynamic counselling as a means of reinforcing both academic identity and promoting well-being and demonstrated that it is a tool clinical psychologists and university teachers could use to activate self-reflection and change within educational settings.     

Life Design Career Counselling with an Abandoned Adolescent: A Case Study

This article describes the value of life design counselling with an abandoned adolescent female. The participant was selected purposively from among a group of abandoned adolescent females who had expressed a need for career counselling. The life intervention comprised two 90-minute sessions per week over a period of a month. Life design data included collage, family constellation, life line, career style interview, asset map and life chapters. Following the intervention, the participant demonstrated career adaptability and an eagerness to take an active part in her evolving life story. Life design counselling has potential to meet the career counselling needs of children with neglect and abandonment experience.     

The European Early Promotion Project: A new primary health care service to promote children's mental health

The number of children in Europe with significant psychologic and social problems is large and increasing. This article describes an innovative crosscultural method of working with families to promote the psychosocial well being of children and prevent the development of psychologic and social problems. A study designed to evaluate the effects of the service is also presented. Primary health care workers in five European countries have been trained to conduct promotional interviews with all prospective mothers in their area one month before and one month after birth. They have also been taught to work with mothers identified as in need of support as a parent by using a specific counselling model to try to prevent the onset of child mental health difficulties. Effects of the intervention on children's psychologic development and family adaptation are being evaluated at two years in comparison with matched groups not receiving the intervention. ©2002 Michigan Association for Infant Mental Health.     

The Social Psychology of Counselling and Psychotherapy: A Base for Integration

The use of interpersonal influence theory as an integrative model for counselling is described. This model relies heavily on theory and research in social psychology in particular, interpersonal power and attitude change. The use of constructs derived from the model is discussed for the three phases of the counselling relationship. Implications of the model for training are outlined.     

Evaluating the effectiveness of counselling intervention with final year undergraduates

This study explores the effectiveness of a short-term counselling intervention model, with final year students, in reducing psychological distress and increasing students' ability to complete their degree programmes successfully. A clinical sample (final year students who consulted he counselling Service) was monitored before and after intervention using the psychometric instrument Symptom Checklist-90-Revised (SCL-90-R) (Derogatis, 1977). A significant reduction in levels of psychological distress was demonstrated with this sample. In contrast a parallel control sample (final year students who did not consult the Counselling Service but whose initial SCL scores were in the same range) showed no significant change in levels of psychological distress over the same time period. The clinical and educational implications of these findings are discussed.     

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.     

“Making things better”: Personal construct counselling for young children

A personal construct counselling approach that we are using with young children is presented here, an approach based on the construct of “wellness”, a medium to promote the well-being of troubled children and their families. The case study we share with you shows a counselling intervention based on play, with experiments drawn from self-related construct systems of “making things better” rather than construct systems of “fixing things up”. We present a case study of a young girl grieving over the death of her father. Emphasis is placed on the relationship of trust between the child and the counsellor, to encourage experimentation with relationship experiences to help the child to reconstrue events outside the counselling context. Working hypotheses drawn from cognitive and emotional developmental research into young children are provided, and the subsequent investigations which guide our intervention. Suggestions for process and outcome research in this area are finally made.     

A thematic analysis of young people's experience of counselling in five secondary schools in the UK

Aim: To investigate young people's views on the effects of school‐based counselling, and what they found helpful and unhelpful. Method: Eleven semi‐structured interviews were conducted and thematically analysed. Findings: Participants expressed predominantly positive views of school‐based counselling with changes in three main domains: emotional, interpersonal and behavioural. Participants viewed these changes as having had an important effect on their lives. The most commonly cited helpful aspects of counselling were related to talking or getting things out, and counsellor qualities. Conclusions: School‐based counselling is viewed positively by those who have experienced it, and appears to be an appropriate and valuable intervention for young people.     

Calculating savings to the nation from counselling services: Methodological challenges

The research endeavoured to develop and pilot a system to demonstrate savings to the nation resulting from counselling provided by a national voluntary agency. This paper demonstrates the methodological challenges encountered. A questionnaire was developed, focused on four broad dimensions of clients’ lives: Employment & Income, Health, Personal & Social, and Children. The questionnaire was piloted by eight counselling centres, and applied pre‐ and post‐intervention. It proved not always possible to attribute clear savings within the dimensions measured. Direct health‐related costs and sick days off work were relatively straightforward. However, for less tangible factors, e.g. personal and social, and children, it was not possible to attribute direct financial amounts to any improvements. The pilot, therefore, attributed savings where possible. Attrition was a major difficulty, with 976 pre‐intervention questionnaires reducing to only 159 post‐intervention. This paper indicates the challenges of estimating savings to the nation from counselling interventions, and illustrates a flexible flowchart which allows savings and costs to be attributed as and when available. Although no final calculations of savings to the nation are included, it is believed that the learning from the methodological challenges encountered should be useful to other services wishing to assess the financial costs and savings of psychological therapies and counselling.     

Applying the principles and techniques of solution-focused therapy to career counselling

Career counselling aims to help clients become more effective agents in solving problems in their vocational aspects of life. To achieve this goal, theorists and practitioners are called upon to form useful helping approaches that can help clients in a more efficient and effective manner. This article proposes an alternative model toward this end by considering and adopting principles and techniques from the solution-focused therapy in career counselling practice. After a very brief introduction of the basic features of the solution-focused counselling, the paper reviews some key theoretical principles of the solution-focused therapy, and connects these principles to career counselling context. It then illustrates several solution-focused counselling techniques that are particularly applicable to career counselling intervention.     

Counselling with Biofeedback: A Review

Biofeedback increasingly appears to be used as an aid to specified counselling goals. A typical counselling situation using galvanic skin reflex (skin biofeedback) is analysed. The ethical and practical challenges involved in biofeedback-aided counselling are considered.     

Using career counselling with group life design principles to improve the employability of disadvantaged young adults

This article explores the effects of group life design counselling on unemployed young adults’ career adaptability skills. Purposive and criterion sampling were used to select 62 participants involved in a skills programme (mean age = 24.86 years, SD = 6.38 years). A quasi-experimental pre-test/post-test comparison group-design, embedded in an intervention framework, was used to gather data. Intervention occurred in the quasi-experimental group. Paired t-tests were used to compare the difference between the pre- and post-test scores obtained on the Career Adapt-Abilities Scale (CAAS). The scores on career concern and career control, as well as the total score on the CAAS, of the quasi-experimental group increased after the intervention. The results suggest that group career counselling interventions with life design principles enhanced the career adaptability in participants as a core element of employability. Future research should focus on more longitudinal research and tracing the long-term progress of participants to establish the value of the approach for diverse clients in (individual and) group contexts.     

A comparison of perceptions of counselling in Ireland and the United States

The present study compared 50 Irish and 50 US graduate and undergraduate psychology and counselling students on the ways they rated counsellors, counselling, and group counselling on a semantic differential. Males were also contrasted to females on these concepts. A 2 2 2 2 2 MANOVA was used for the data analysis where the independent variables were country, class, and gender, and the dependent variables were the evaluative and potency scales of the semantic differential for counsellors, counselling, and group counselling. The Irish sample rated the potency of counselling significantly higher as did women. Counselling graduates evaluated group counselling and counsellors significantly higher than psychology undergraduates.     

The advantages and disadvantages of a brief intervention strategy in a community counseling service

Abstract

The Isis Centre, a long-established NHS open-access counselling facility in Oxford, experienced excessive demand for service. This placed strain on the capacity to deliver, and an unacceptably long waiting list resulted. A brief intervention strategy limited to four counselling sessions was shown to reduce the waiting time. This outcome study tests the hypothesis that the strategy was sufficiently clinically effective to warrant its continuing availability to those who wished to be seen more quickly, rather than waiting for an open-ended contract. Counsellors assessed outcome on clinical parameters and clients were retrospectively asked their views on the acceptability of the method and its usefulness.

There was a high level of correlation between clients' and counsellors' assessment. One-quarter of the study group had an experience classified as ‘useful and sufficient’. However, half felt the experience ‘useful but insufficient’, although this group also thought the intervention provided more than temporary relief. For one quarter, the experience was not helpful, but for some of these it prevented a long, unnecessary time on the waiting list.

While a brief intervention appears to be an effective strategy in delivering a counselling service, further work is necessary to target those most likely to benefit and those for whom a longer-term option should be sought from the start.     

Enhanced counselling for women undergoing BRCA1/2 testing: Impact on knowledge and psychological distress–results from a randomised clinical trial

This randomised controlled trial evaluated the impact of an enhanced counselling (EC) intervention on knowledge about the heritability of breast and ovarian cancer and distress, as a function of BRCA test result, among high-risk women. Before deciding about whether or not to undergo genetic testing, participants were randomly assigned to the EC intervention (N = 69), designed to promote cognitive and affective processing of cancer risk information (following the standard individualised counselling session), or to the control condition (N = 65), which involved standard individualised counselling followed by a general health information session to control for time and attention. Women in the EC group exhibited greater knowledge than women in the control group, 1 week after the intervention. Further, at the affective level, the intervention was found to be the most beneficial for women testing positive: specifically 1 week after test result disclosure, women in the intervention group who tested positive experienced lower levels of distress than women in the control group who tested positive. The findings suggest that the design of counselling aids should include a component that explicitly activates the individual's cognitive–affective processing system.     

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.