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.     

Counsellor interpretations and the occurrence of in-session client change moments in non-dynamic psychotherapies

This study explored the relationship between therapist interpretations and optimal in-session client processes in 20 sessions conducted by exemplary psychotherapists of three different theoretical orientations: Client-Centred Therapy (CCT), Rational-Emotive Behaviour Therapy (REBT), and Gestalt/Existential Therapy (GT). The results indicated that interpretations were used with similar frequency across therapeutic approaches, but they were neither superior nor inferior to other interventions in relation to the occurrence of optimal in-session client processes. The results support the notion that interpretation is a commonly used therapist intervention and that different therapies accentuate different aspects of interpretation. Implications for psychotherapy integration are offered and the findings are discussed with reference to theory and clinical practice.     

Helping the reluctant client to engage in counselling

The reluctant or resistant counselling client is a common though frustrating client for many school counsellors. A number of techniques designed to aid reluctant clients to engage in the process of counselling are described.     

Clinical and demographic features of the online counselling client population

The purpose of this research was to determine the demographics and characteristics of clients seeking online counselling over an eight‐month period of clinical online practice. Two hundred and seventeen clients seeking Internet counselling completed a Counselling Application and a Life History Questionnaire. The characteristics of the relatively new client population include the following categories: gender, age groups, martial status, education, primary reason for seeking online therapy, secondary issues, frequency of email exchanges, and online vs. face‐to‐face counselling preferences. Implications for online counselling practice are discussed.     

Client perceptions of hindering experiences in counselling

The purpose of this study was to increase understanding of what clients perceive as hindering experiences in counselling. In‐depth interviews combined with concept mapping were used to gather, organize, and understand clients' perceptions of hindering aspects of therapy. In the initial data gathering stage, 8 adult client participants, aged 18 or older (average of 14.1 sessions) were asked to respond to the following open‐ended questions:

相似文献   

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.     

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.     

Interviewee perceptions of an organisational careers guidance scheme

A study was carried out during the early stages of the introduction of a career development scheme in a large government department. Information relating to aspects of various careers counselling issues was gathered from staff who had received such counselling and from personnel staff responsible for its provision. The study shows, amongst other things, that the interviewers were perceived to use some counselling skills, that the interviewers claimed they experienced few problems of role conflict, but that the staff tended to identify the interviewers with management. The findings are discussed relation to the appropriateness of interviewing style and to the broader context of how individuals might influence their career development within the opportunities provided by the organisation.     

The client as expert: Researching hindering experiences in counselling

This paper identifies the importance of valuing clients’ experiences when seeking to understand hindering experiences in counselling. Since the research literature reports that client perceptions of counselling are better predictors of outcome than counsellor ratings, client viewpoints are critical to furthering understanding of hindering experiences. Clients are generally reluctant to share negative experiences and a discussion regarding the difficulty in soliciting these experiences is presented. Examples of the process of conducting a client-oriented investigation into hindering experiences convey some of these difficulties. Several implications for counselling practice are addressed: (1) the need for counsellors to notice and repair hindering experiences, (2) the value of attending to the quality of the relationship, (3) the need for counsellors to cultivate flexibility and responsiveness, and (4) the use of methods to encourage clients to share their unspoken experiences.     

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.     

Counsellor role perceptions and preferences of Zimbabwe teachers of a Shona cultural background

Thurstone's Case V paired comparisons procedure was used to investigate the perceived role status and preferences of counsellor for a sample of Zimbabwe teachers of a Shona cultural backgroud (n = 312) in relation to type of presenting problem (personal; educational; employment) and as the teachers varied by gender, age, level of formal educationa and marital status. Counsellor expertise contrasted those of modern status (psychologist; church pastor; work supervisor) and traditional status (family members; traditional healer; friend). The teachers seemed to have an undifferentiated perception of counselling needs as measured by preferences for helper. Age jand level of formal education were significantly related to counsellor prefernces, with the older and less schooled teachers tending to endorse counsellors of a traditional status. The results are considered with respect to the provision as well as public image of counselling services in an African culture.     

The effectiveness of UK student counselling services: an analysis using the CORE System

Despite concern surrounding the mental health of students, brought about by the government's policy of widening participation and increasing demands upon students, the effectiveness of student counselling has been a neglected research area. This study examines data from seven UK student counselling services using the CORE System in the routine evaluation of their services. Results indicate that counselling is effective, with 70% (service range 67% to 83%) of clients with outcome measures available showing reliable improvement on the CORE-OM from pre- to post-therapy. However, students who complete a course of counselling show significantly greater improvement, according to practitioner pre- and post-therapy severity ratings of depression and anxiety, than those clients who drop out or have an unplanned therapy ending (effect size 1.03, 0.85, respectively). The stage at which students drop out of therapy is important, with those students dropping out of therapy before the third session being the most vulnerable. The implications of these findings are discussed.     

Pupil perceptions of counselling: A case study

Using a case-study school with a highly-developed counselling service employing three trained school counsellors, pupil perceptions of counsellors are examined in terms of their duties within the school and their potential helpfulness. Despite the fact that many of the features of the school were ideally adapted to the effective development of counselling, the counsellors were broadly perceived as senior teachers with a great deal of administrative responsibility. Few of the pupils indicated a willingness to approach any of the counsellors voluntarily with a personal problem.     

The client as a self‐aware agent in counselling and psychotherapy

Clients' recollections of their experiences of counselling and psychotherapy were stimulated using the technique of Interpersonal Process Recall. Their reports were analysed in terms of the grounded theory method of qualitative research. The analysis resulted in the interpretation that the core category of their experience is clients' reflexivity, or self‐awareness and agency flowing from it and returning to it. The focus of this paper is directed at the client's reflexivity in response to the counsellor's operations. Its organizing theme is that how clients respond to counsellors' operations depends on what clients desire and what they feel they can say safely. Particular desires arise from an over‐arching desire either to enter into or avoid inner experience. Moreover, the relation with self is influenced by the relationship with the therapist. This complexity makes it difficult to predict responses to non‐directive and directive counsellor performances alike. Vignettes selected from the participants' reports illustrate the theme. Implications for the practice of counselling and psychotherapy are discussed.     

Psychodynamic counselling for the borderline personality disordered client: A case study

Psychodynamic counselling for clients with borderline personality disorder is difficult and challenging because there are problems with the validity of the concept, diagnosing the disorder, managing disturbed behaviour and maintaining the treatment to successful completion. Nevertheless, counsellors are frequently called upon to provide assessment, management and treatment for this group. This article explores the application of psychodynamic principles of counselling to clients with borderline personality disorder, examines the history of the concept, the diagnostic process, and employs a case presentation to help describe aspects of character structure and treatment.     

An analysis of the effectiveness of university counselling services

It is important to demonstrate replicable evidence of the effectiveness of counselling procedures. The study aimed to contribute to the currently limited evidence base examining the effectiveness of university student counselling in the UK. Information on therapeutic outcome [based on Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores] for 305 individuals attending a large UK university counselling service was analysed. Following counselling intervention: there was a statistically significant improvement in CORE-OM scores with 63% of individuals showing a reliable improvement and only 2% showing a reliable deterioration. Of those who began with a score in the clinical range, 49% showed a clinically significant change. These results provide additional evidence for the effectiveness of university counselling interventions. Future research should aim to build on this preliminary research using randomised controlled trial designs.     

Avatar‐based counselling for young people within school counselling. Qualitative analysis of client experience

Background

This study is a qualitative analysis of clients’ experiences of a new avatar based counselling intervention, based on the ‘ProReal’ software ( www.proreal.world ). The intervention was piloted in eight secondary schools in the UK in 2016.

Aims

Twenty‐nine participants (53% of the full sample) were interviewed about their use of the software, experience of the intervention, process of change and views about its helpfulness.

Materials and Methods

Interviews were semi‐structured and were analysed using thematic analysis.

Results

The analysis shows that the intervention was potentially attractive to these clients, particularly those enthusiastic about digital software and clients who found visual communication helpful. The software provided additional opportunities for clients to communicate their inner worlds to the counsellor and supported the development of insight. Male clients, in particular, commented on its helpfulness.

Discussion

There is an indication that digital imagery supported the process of change in counselling and the development of meaning bridges: both internally and with the counsellor (Stiles, 2011; Stiles et al., 1990). However, the software could be experienced as an obstacle when clients wanted to talk about specific problems or ‘vent’ their feelings. All clients who reported that they did not find the software helpful were female. There were a number of suggestions about developing the software to increase opportunities for expression as well as appropriateness for clients from different minority ethnic backgrounds.

Conclusion

Use of digital software in counselling has a potential to enhance communication and support a process of change, particularly with male clients, those who find visual communication helpful, and clients enthusiastic about digital technology. Further research is needed to develop the intervention and compare it to the use of other creative media in counselling.     

The impact of waiting-list times on client attendance for relationship counselling

The impact of waiting-list times on subsequent attendance for appointments has received extensive attention within the area of health, but hitherto has received relatively little interest from counselling services. Given the current pressure on all welfare agencies for accountability and efficient use of resources, counselling organisations need to consider resource usage and barriers to efficiency. A study was therefore made of one aspect of this issue: the impact of short v. long time-delays between initial referral and first appointment for relationship counselling. It was found that clients offered appointments within two weeks of referral were significandy more likely to attend for first appointment than were clients whose appointment came between 4 and 12 weeks post-referral. The implications of these results for organisational policy are discussed.     

Exploring counsellor perceptions of the impact of counselling supervision on clients

This qualitative study explores counsellors’ experiences and perceptions of how counselling supervision impacts upon their clients. Data collection combined open‐ended questionnaires (n = 13) and semi‐structured interviews (n = 6). The findings indicate that supervision impacts client work both helpfully and unhelpfully. Areas that emerged as having the most direct impact on client work were the counselling relationship dynamics and self‐awareness, professional development, emotional support, clients not discussed in supervision and the quality of the supervisory relationship. Congruence and confidence were the most direct link between supervision and client work.