Value for money?: Issues of fees in counselling and psychotherapy

Drawing on literature from different psychotherapeutic traditions, the meaning of money is reviewed, and the psychological and practical issues which arise from the setting, changing and payment of fees in counselling and psychotherapy are discussed. A person-centred approach is offered as a framework for the counsellor's understanding of fees in the therapeutic relationship.     

Taking counselling and psychotherapy outside: Destruction or enrichment of the therapeutic frame?

This paper will explore emerging issues in the practice of counselling and psychotherapy in the outdoors, which the authors encountered when they took their clients outside of the traditional therapy room. The outdoors is defined as natural areas and spaces, such as woods and parks which have been termed ‘nearby nature’ (Kaplan &; Kaplan, 1989 Kaplan, R. Kaplan, S. (1989). The experience of nature a psychological perspective. New York: Cambridge University Press [Google Scholar]) and also more remote areas such as mountains and moors which are more isolated from civilisation, what some have termed wilderness (Mcfarlane, 2007). Particular emphasis will be given to the ‘frame’ of psychotherapy and how aspects of this are affected by moving outdoors, in particular contracting in relation to confidentiality and timing. The relationship in psychotherapy will be explored in relation to issues of mutuality and asymmetry alongside the role of nature in the therapeutic process. Lastly the challenges and therapeutic potential of psychotherapy in nature will be explored.     

An existential-phenomenological perspective on the concept of ‘resistance’ in counselling and psychotherapy

The various phenomena that are categrised under the label of ‘Resistance’ are of central concern to most models of counselling and psychotherapy. The manner in which resistance is conceptualised has vital implications for therapists approach to the therapeutic relationship. The theory of resistance in classical Psychoanalysis and Cognitive Behavioural Therapy (and particularly Rational Emotive Behaviour Therapy) is examined and then compared to the radical reinterpretation possible in an Existential-Phenomenoogical perspective which promotes the rejection of the role of ‘therapist as expert change agent’.     

Research into therapists’ perceptions of therapeutic change using vignettes and aMSN messenger

This article describes a research approach to investigating the ways in which therapists understand the nature of therapeutic change. The research was based in qualitative, narrative approaches to in-depth analysis of vignettes provided by drama therapists. The article describes the approach to the generation of data through the internet by aMSN messenger. It reports on the approach taken to the analysis of data along with samples from the findings.     

Social justice and remembering “the personal is political” in counselling and psychotherapy: So,what can therapists do?

This brief contribution argues for the importance of a social justice perspective in counselling and psychotherapy, particularly within the current international socio‐political context. Much has been said about social justice over recent years in the fields of psychology, psychotherapy and counselling. Professionals and academics have expressed some concerns about what it might actually mean, or how difficult it might be in practice to engage with this perspective. In this paper, the activist phrase “the personal is political” (Hanisch, 1970) is used to illustrate the way in which a social justice approach to counselling and psychotherapy does not need to be complicated, but rather a foregrounding of a particular understanding of well‐being and the people we work with. Following this, some concrete and straightforward suggestions for how therapists might begin to act on their social justice values are made.     

A review of: “Challenges to counselling and psychotherapy”

Alex Howard (1996) Challenges to Counselling and Psychotherapy, London: Macmillan, $11.99     

‘That psychotherapy and counselling trainings should be based in universities’

Psychoanalytic institutes, operating as they do normally outside universities, have been criticized as being like religious institutions, with the emphasis on a narrow set of beliefs more than on critical examination of ideas, and with considerable power invested in the trainers and supervisors. Such criticism may also apply to other schools of psychotherapy. While universities have their own difficulties as institutions, including bureaucracy and even similar standardization of theories in particular disciplines, they can also represent a challenging milieu for psychotherapy and counselling education, for accountability in selection, teaching and assessment, for student participation, and for a broader critique of ideas. The difference between education and training is noted and a two-part assessment, academic and practical, is briefly considered.     

A healing relationship: Clients’ experiences of the long-term relational significance of the horse in horse assisted psychotherapy

Horse assisted psychotherapy is a type of treatment for mental ill-health in which the client forms a relationship with a horse. Research suggests that the relationship to a horse is very helpful to clients, but how the horse is experienced many years after the end of treatment has not been investigated. The aim of the present study was thus to investigate how former clients from horse assisted psychotherapy experienced the horse several years after treatment was completed. Former clients (n = 5; all females) from one and the same treatment center were interviewed and the data was analyzed with an inductive thematic approach. The analysis showed that many years after completion of treatment, the horses were still remembered as the most important individuals in the informants’ lives during the time of treatment. This was captured by the core category ‘A healing relationship’. These findings are in line with previous research that found that patients in horse assisted psychotherapy and their family members attributed improvements from treatment to the patients’ relationship to the horses, but adds that the clients also keep these views at follow-up several years after termination of treatment.     

Psychological type and counselling psychology trainees’ choice of counselling orientation

Clarifying the factors which influence choice of counselling orientation is important. This study investigated whether psychological type is associated with choice of orientation in counselling psychology trainees. Sets of questionnaires were sent to 210 counselling psychology trainees in four universities, which resulted in a sample of 84 participants. The measures were the Keirsey Temperament Sorter II and a short demographic questionnaire which also asked open-ended questions about chosen orientation. Participants who preferred SJ (Sensing-Judging) were more likely to choose the CBT model, NFJ (Intuition-Feeling-Judging) types the Psychodynamic model and NFPs (Intuition-Feeling-Perceiving) the Person-Centred model.     

A review of: “Implausible professions: Arguments for pluralism and autonomy in psychotherapy and counselling”

R. House and N. Totton (eds) (1997) Implausible Professions: Arguments for Pluralism and Autonomy in Psychotherapy and Counselling, Ross-on-Wye: PCCS Books, pp. 348, $14.00 (pb) (8% discount direct from publishers)     

Desire for personal feedback: Who wants it and what does it mean for psychotherapy?

Individual differences in desire for feedback did not exhibit any significant correlations with a variety of self-report personality dimensions. Additional survey studies indicated that a higher proportion of individuals in nonclinical as compared to clinical samples reported a strong desire to receive feedback about themselves. Subsequent studies revealed that the higher as compared to lower desire for feedback individuals: (1) were more willing to seek psychological help and to participate in therapy once in treatment; (2) exhibited more positive expectancies for change at the beginning of therapy; and (3) were more “responsive” to diagnostic feedback. Within the limitations of the present findings, the potential “adaptiveness” of desire for feedback is discussed and the negative motivational therapeutic consequences associated with a low desire for feedback are explored.     

Therapists’ self-reported chronic strategies of disconnection in everyday life and in counselling and psychotherapy: an exploratory study

The aim of this study was to explore how therapists believe they may relationally disconnect from other people and their clients, with an overall objective of developing methods for enhancing relational depth in counselling and psychotherapy. Participants were 168 trainee and practicing therapists, who listed their chronic strategies of disconnections (CSoDs) in everyday relationships, and then rated the presence of these CSoDs in their therapeutic work. Thirty-nine categories of self-reported everyday CSoDs emerged, organised into seven domains. Most prevalent were behavioural, passive and intrapsychic strategies. Over half of the CSoDs were rated as being present in therapy to a minimal extent, most commonly passive CSoDs, disingenuous CSoDs and humour. Male therapists, and trainee therapists, were most likely to identify their CSoDs as present in therapy.     

Trainee therapists’ views on the alliance in psychotherapy and supervision: a longitudinal study

The shape of alliance in psychotherapy and supervision using growth curve modeling was examined for clinically inexperienced trainee therapists, who were engaged in long-term cognitive behavioral - or psychodynamic individual psychotherapy at a Psychology Clinic in Sweden. Trainee therapists rated their view of the alliance with their clients and their supervisors on the Working Alliance Inventory at five time points. The alliance to the client show a consistent, positive development throughout the therapy. The alliance to the supervisors show initially a decrease, followed by an increase, and then again, the rate of increase in the supervisory alliance ratings slowed down indicating a more complex view of the supervisory alliance compared to the view of the alliance in psychotherapy.     

The integration of psychotherapy: Goal or utopia?

Both researchers and therapists stress the importance of integrating different forms of psychotherapy. Integration may be achieved in three ways. Supporters of the “empirical strategy” believe that more research is the solution. Followers of the “conceptual strategy” try to theorize on psychotherapy using psychological and sociological concepts. Other researchers see a “linguistic strategy” as the way to achieving a better understanding of psychotherapy. Whether any of these strategies will enable us to increase our insight into psychotherapy is questionable. All focus on technical aspects, that is, on the means to achieve effects. Yet, therapeutic effects cannot be understood unless they are interconnected with diagnostics. This paper argues that an integrated theory should be developed which includes diagnostics and treatment and which is supported by a theory on psychological (dys)functioning.     

Psychological counseling as an adjunct to stuttering treatment: Clients’ experiences and perceptions

PurposeStuttering can trigger anxiety and other psychological and emotional reactions, and limit participation in society. It is possible that psychological counseling could enhance stuttering treatment outcomes; however, little is known about how clients view such counseling. The purpose of this study was to gain an understanding of clients’ experiences with, and perceptions of, a psychological counseling service that was offered as an optional adjunct to speech therapy for stuttering.MethodNine individuals who stutter (13-38 years old) participated in semi-structured interviews. Six participants had taken part in psychological counseling; three participants did not do so. Interview data were analyzed using grounded theory as a guiding framework.ResultsFour thematic clusters emerged from participants’ accounts: insights into personal decision-making, why others may not participate in counseling, psychological counseling as a worthwhile part of therapy, and counseling as a necessary component in a stuttering treatment program.ConclusionIn addition to experiencing barriers and facilitators to help-seeking that are reported in related fields, participants accounts also revealed novel facilitators (i.e., a ‘why not’ mentality and the importance of having a pre-existing relationship with the clinician who offered the service) and barriers (i.e., viewing the service as a ‘limited resource,’ and, the overwhelming nature of intensive stuttering treatment programs). Findings suggest that clients value the option to access psychological counseling with trained mental health professionals to support the stuttering treatment provided by speech-language pathologists. Participants made recommendations for the integration of psychological counseling into stuttering treatment programs.