Barriers and challenges in the practice of multicultural counselling in Malaysia: A qualitative interview study

Counsellors face a lot of problems and stressors in their daily lives. As a person, counsellors may face challenges to deal with their personal expectations and responsibilities in life, work, family and community. As a professional, counsellors may face difficulties in dealing with professional issues and ethical dilemmas in their professional practice such as countertransference and value conflicts. These raise issues concerning their perceived multicultural competence and the adequacy of their training. Informed by a multicultural counselling perspective and drawing on semi-structured interviews with 12 professional counsellors in Malaysia, this study discusses the types of barriers and challenges faced by Malaysian counsellors and how these challenges were manifested and addressed in the cross-cultural counselling sessions. Results revealed five emerging themes based on participant counsellors’ responses on the barriers and challenges encountered in their practice of multicultural counselling in Malaysia. These were challenges related to counsellors’, clients’, presenting issues’, third-party and specific contexts’ characteristics. Research implications for the education and training of counsellors in the specific Malaysian socio-political context are also discussed.     

Christian counsellors' views on working with gay and lesbian clients: Integrating religious beliefs with counselling ethics

Thirty‐one counsellors who identified themselves as practising, committed Christians, returned completed questionnaires that investigated how they integrate their Christian beliefs with their professional ethical code when counselling gay and lesbian clients. It was found that although most respondents believed that they were able to accept gay and lesbian clients, a minority demonstrated incongruence in relation to members of this client group, and were judgmental about perceived gay/lesbian behavious. Counsellors who took a rational stance in their understanding of the Bible and Christianity expressed more open and accepting views. Counsellors with a literalist approach to the Bible appeared to be lacking in acceptance and were unaware that they may not be offering the core condition of respect to their gay or lesbian clients. These findings are discussed in terms of their implications for supervision, research and practice.     

Spiritual emergency and counselling: An exploratory study

Growing up in a multicultural community in England brought me into close personal contact with the beliefs and perceptions about healing held by people of many different cultures. In many cases, no strong boundary was seen between physical, psychological and spiritual aspects of an illness, and experiences of hearing voices or seeing visions were accepted as normal everyday occurrences. During my training as a counsellor, I came into contact with the work of Stanislav Grof on the concept of spiritual emergency, which, together with the work of African and European authors who were exploring transpersonal aspects of psychology, provided a theoretical framework for researching how counsellors respond to clients wishing to explore experiences of spiritual crisis. This paper describes an exploratory study into the phenomenon of spiritual emergency within counselling. Questionnaires were distributed by post to people known to have been in counselling relationships, and interviews were conducted with three informants reporting different types of spiritual experience. All respondents who completed questionnaires reported having at least one of the ‘non‐ordinary’ experiences classified by Stanislav Grof as characteristics of a ‘spiritual emergency’. Several participants felt unable to explore this experience with their counsellors, some for fear of being labelled as mentally ill, while others found their counsellors helpful and sympathetic. Differences in dealing with spiritual phenomena were apparent between European and non‐European participants. These findings are discussed in relation to theory and practice.     

Marriage guidance counselling: I. What clients think will help

Thirty-one first-time attenders for marriage guidance counselling were given a non-schedule standardised interview and a client questionnaire. The main aim was to identify the counselling and counsellor characteristics which clients considered would be most helpful in dealing with their problems. Traditional counselling skills such as the ability to be warm, supportive, understanding and a good listener were seen to be important by most clients. However, the vast majority of clients indicated that it would be helpful to receive the counsellor's opinion about their marriage, their personal problems and marriage in general: this is incompatible with a non-directive approach to counselling. Whilst clients may not know best how they should be helped, counsellors who fail to address their preconceptions risk mutual disappointment and premature termination of counselling.     

Pupils as consumers: Perceptions of guidance and counselling in a scottish school

Pupils' perceptions' of the effectiveness of counselling services were investigated within a school with a high degree of commitment to guidance and counselling. Pupils were asked to read eight problems: four were school-based, and four were personal/familial problems. Half the sample were given a list of possible sources of assistance (including counselling staff); half were unprompted On personal and familial problems, the unprompted group were as likely to cite counsellors as being sources of assistance as were the group prompted with the names of counselling staff. This was taken as an indication that counselling staff were spontaneously seen as sources of help on these matters. In addition, respondents completed semantic-differential protocols, analyses of which indicated that counselling staff were seen in more pastoral terms than were other teaching staff. These results are discussed within a perspective that sees the school's guidance and counselling system as interacting with its general ethos.     

Adventure based counselling,individual counselling and object relations: a critical evaluation of a qualitative study

Adventure based counselling is a short-term experiential psychotherapeutic approach, which utilises adventurous activities and being in natural environmental in order to facilitate therapeutic change in clients. The present paper critically appraises the results of a qualitative study that investigated how clients with self-reported anxiety and depression experienced participating in an innovative counselling intervention with combined individual counselling with such an adventurous outdoor transaction. Interpretative Phenomenological Analysis, as described by Smith and Osborn (2008), was used in order record and analyse the experiences of four male and six female students who were treated at the Teesside's University Counselling Service. Interviewees perceived the counselling sessions as offering a safe therapeutic space within which they could unveil their anxieties and achieve inner healing, whereas the outdoor transaction as providing an experiential venue for achieving personal change. Interviewees felt that without the outdoor transaction the therapeutic significance of the counselling process would not have reached its full potential. Likewise, without the individual counselling, the outdoor transaction would just have an entertaining event and not a venue for personal change. These findings are discussed in relation to object relations theory.     

Clients talk about their experience of seeking counselling

The purpose of this study was to explore the help-seeking behaviour of a sample of counselling clients using a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in, affordable counselling agency located in a mid-sized city in New Zealand. Specifically, clients were asked if they had received counselling previously, what efforts they had made to solve their problems before seeking counselling and with what success, why they chose this particular agency, their initial impression of their relationship with their counsellor, and their reactions to participating in the research. The data were analysed to ascertain themes associated with their decision-making and choices. Findings were discussed in relation to the literature on seeking counselling, how clients determine their need for counselling and the process they go through in deciding when and where to get it. Implications for counsellors are discussed.     

A qualitative evaluation of an employee counselling service from the perspective of client,counsellor and organization

An evaluation of a Fire Brigade counselling service examined the viewpoints of all three stakeholders (clients, counsellors and organization), using a multi-method approach using interviews, questionnaires and staff records. All parties expressed satisfaction with the provision, but noted the need for better communication and marketing. The counselling service was demonstrated to be needed and effective in both human and fiscal terms.     

Responses to Marriage Counselling

The experiences of clients who received marital counselling from trained volunteer marriage guidance counsellors were investigated. Fifty-one clients from 42 marriages were interviewed and questioned about why they chose the agency, what expectations they held, what happened during counselling, how they felt about the counsellor, and what if anything was achieved through counselling. They were also asked how they had fared since. Rating scales were used after the interview to evaluate satisfaction with counselling, benefit from counselling, aspects of the counselling relationship, etc. The clients were also asked to do a card-sort of statements about counselling to determine what aspects had been valuable and disappointing. Some of the preliminary results of the study are presented and discussed.     

Online counselling: The experience of counsellors providing synchronous single‐session counselling to young people

Kids Help Line (KHL) is a national Australian youth counselling service that provides free online and telephone counselling. This qualitative study examines the experience of 26 online KHL counsellors. Using a focus group methodology, counsellor responses were organised into categories: privacy and an emotionally safe environment; communication through text; and time. Counsellors reported the main benefit of the online environment to be emotional safety, due to reduced client emotional proximity to the counsellor, and the main disadvantage to be that reduced emotional proximity and the absence of non‐verbal cues could result in communication problems and difficulty in accurately assessing young people's concerns. Time proved a significant issue for counsellors, as the slow speed of text exchange could limit their ability to complete interventions. Methods that enhance both the process and effectiveness of online counselling are needed. Potential solutions to the challenges faced by online counsellors are discussed.     

Client-counsellor agreement on what happens in counselling

This study used parallel questionnaires to gauge the level of agreement between 31 pairs of clients and their counsellors. Topics investigated included clients' help-seeking behaviour, the working relationship, events regarded as helpful and unhelpful, the importance of counselling versus outside factors in achieving positive outcomes, and terminating. Results indicated that there was group agreement between clients and their counsellors on many aspects of their counselling experience. However, pair-specific agreement was less common with levels varying from low to moderately high. The findings suggest that understandings of the client/counsellor relationship based on group analyses can mask the actual relationship revealed by pair-specific analyses. The findings are discussed in relation to the existing literature and implications for practice are suggested.     

Struggling with self: The personal projects of students seeking psychological counselling

Personal projects can be described as self-articulated goals and related sequences of actions. In order to investigate what kind of personal projects people with psychological problems have, and how they work on them, 28 counselling client students, 44 students of psychology, and 45 students of technology completed a Finnish version of Little's (1987) Personal Project Inventory. The results showed that the clients scored lower on project accomplishment than other groups. Their personal projects were frequently self-related, while those of the technology students were often task-related. The higher their sense of coherence, self-esteem, mental health and life satisfaction, the more subjects expected to accomplish their projects, the more frequently they described task-related projects, the less negative affect they reported, and the less frequently they described self-related projects. These results suggest that psychologically distressed individuals struggle with self-related projects and have problems in accomplishing their projects.     

A humanistic developmental model of counselling: A psycho-educational approach

A developmental model of counselling, based on humanistic principals of psychological functioning, is proposed. A psycho-educational approach, in which counsellors are seen as helping clients develop skills rather than solve problems, is discussed. The counselling model involves three stages: exploration, intervention and empowering. The intervention stage includes techniques focused on affect, behaviour or cognition, as suggested by the ABC model of personal change described in the paper.     

A profile of counsellors working in non-statutory alcohol services

There are 39 voluntary sector alcohol agencies in the UK who meet minimum standards of counselling set out by the national organization Alcohol Concern through their Volunteer Alcohol Counsellors Training Scheme (VACTS). This paper reports on a study to create a profile of volunteer counsellors who work in VACTS-recognized agencies. Fifeen agencies agreed to take part in the study, and 141 counsellors completed and returned a mailed survey questionnaire, to elicit information about demographic characteristics, current and previous counselling training, reasons for undertaking the VACTS training and level of experience within agencies. The results suggest that this cohort of counsellors tend to conform to the volunteer stereotype of the middle-aged middle-class woman. Many counsellors utilize their experience within agencies to develop counselling skills, often in connection with further counselling courses, or to consider a change in career direction. Some counsellors wish to use personal experience of alcohol problems to help others undergoing similar difficulties. In contrast to those in the generic volunteer field, counsellors appear to retain long-term involvement with their agencies. The study concludes that alcohol services in the UK rely greatly upon a group of committed and competent volunteers to deliver individual counselling to problem users of alcohol.     

An initial study of transgender people's experiences of seeking and receiving counselling or psychotherapy in the UK

Background: There are no published empirical research studies exploring transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. As a result, counsellors know little about why transgender people seek counselling, who they seek counselling from, and what their experiences are of receiving counselling. Aim: To address this gap in the literature, this study investigated transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. Funding for this study was provided by a BACP Seedcorn grant. Method: A mixed method small‐scale qualitative research design was employed, comprising an online survey and five semi‐structured interviews. Findings: Participants tended to seek counselling on two or more occasions and received between 2 and 12 sessions. Participants sought counselling for common psychological concerns as well as gender identity and coming out issues. A fear of being discriminated against and exploring gender for the first time were significant barriers in seeking help. Participants reported mixed experiences of counselling but valued a therapeutic relationship in which they felt affirmed, listened to and understood. Discussion: The findings from this study mirror aspects of previous research conducted in the USA concerning transgender clients' experiences of counselling. However, these findings point to the importance of recognising the potential vulnerability transgender clients experience when seeking counselling and the need for therapists to develop greater awareness, knowledge and competence regarding working with transgender clients.     

Counselling problem drinkers: The realm of specialists. Alcoholics Anonymous or generic counsellors?

A study was carried out to investigate counsellors' attitudes and experiences in working with people with drinking problems and counsellors' understanding of Alcoholics Anonymous as a helping agent. Ninety-four counsellors responded to a questionnaire about their work with people with drinking problems and their knowledge of AA. Generic counsellors tended not to feel competent working with clients with alcohol problems. Feelings of competence increased with greater experience of the client group and, to a lesser extent, with more hours of specialist training. It was found that counsellors whose intake of alcohol amounted to more than eight units per week were less likely to take on clients with alcohol problems than were those who drank less. Counsellors usually had some knowledge of AA but had little understanding of the 12-step programme that forms the basis of recovery for alcoholics as described by AA. They were, however, in favour of clients attending AA as an adjunct to individual counselling     

Client perspectives: The therapeutic challenge of domestic violence counselling – a pilot study

Aims: This qualitative pilot study explored the perceptions of four female domestic violence clients regarding counselling they had concluded in order to identify a preliminary client‐preferred domestic violence counselling approach. Method: Semi‐structured interviews asking about significant events during counselling were held. An adapted grounded theory and narrative methodology was used. Results from the analysis were reviewed with two of the participants. Participants were offered additional counselling support if required after the research interview. Results/Findings: Domestic violence clients found starting counselling particularly difficult after years of keeping the abuse to themselves. Participants actively withheld and managed information for several sessions and needed to know they had time to explore their experiences. The counsellor being consistent and non‐judgemental, and understanding domestic violence and its effects was helpful. Having a clear ending was appreciated by the participants. Discussion: The initial development of the therapeutic relationship benefited from active discussion of how domestic violence could affect behaviour and emotions. Good early therapeutic relationships showed elements of the three main psychological schools. Participants benefited from a pro‐active discussion of endings. A key limitation of this research is the small sample size. Implications for practice: The research suggests that counsellors would benefit from knowledge and skills from different psychological schools and specific training in domestic violence. Allowing flexibility on the number of sessions available to clients may be helpful. Conclusions: Further work is required to explore these preliminary findings. However, early indications suggest that domestic abuse clients may benefit from non‐time‐limited specialist counselling services.     

Using the sixth sense: The place and relevance of language in counselling

Counsellors' primary skills, apart from listening to clients' words, lie in responding with well-chosen words. Ideal counsellors say just the right thing, at just the right time, in just the right way. It is suggested that emphasising how words relate to cognitive, emotional and relationship events can take counselling on to new ground. In addition to felt experience being in sight, sound, feeling, smell and taste, language itself is posited as a 'sense' through which we perceive, and are joined to, our environment. From the starting point that counsellors use words to heal, attention is paid to how wrong words injure clients, how words are a major component in making relationships, and how they create and define felt experiences. 'Metaphorical schemas' are posited as bases for shaping felt experience. These schemas are a theory of subjectively felt emotion and cognitive understanding.     

Counsellors' perspectives on the use of the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) in an alcohol counselling setting

As part of a randomised controlled trial to investigate the feasibility of using the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) within an alcohol counselling setting, counsellors' views of using the tool were sought. Data about the service users' use of SEIQoL were collected during the counselling session, and focus groups and questionnaires were used to collect data on counsellor perceptions and experiences of using the tool. SEIQoL was easy and quick to use and provided users with a graphic, visual and dynamic means to identify important areas that contributed to their quality of life; it appeared to enhance the reflective process early on in counselling. Counsellors reported that service users requested the tool be used more frequently during the counselling process and they felt it could be a useful review tool.