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.     

Report from the UK and Eire Association of Genetic Nurses and Counsellors (AGNC) Supervision Working Group on Genetic Counselling Supervision

The Association of Genetic Nurses and Counsellors (AGNC) is the professional organisation which represents genetic counsellors and genetic nurses in the United Kingdom (UK) and Eire. The AGNC recognises that genetic counselling supervision is instrumental to the practice, training and registration of genetic counsellors in the UK. The AGNC formed a Supervision Working Group, whose terms of reference were to collate information on supervision and create a list of ‘best practice’ recommendations for its genetic counsellor members. This report delivers the findings from the Supervision Working Group and has been peer reviewed by the AGNC membership in the UK and Eire and ratified by the AGNC Committee. It offers a working definition of genetic counselling supervision, gives an overview of some of the literature on supervision and concludes with practice recommendations. Group Authorship: AGNC Supervision Working Group Membership of the AGNC Supervision Working Group     

The responsibilities of counsellor supervisors: A qualitative study

A study was carried out to investigate whether supervisors of counsellors considered themselves to be clinically responsible for the work of their supervisees, what responsibilities they considered themselves to have for the counsellors' work, and how they managed their responsibilities. The purpose of the study was to enhance the counselling profession's understanding of the responsibility of supervisors and of the supervisory relationship. The study was confined to supervisors working in private practice. Ten experts in the field of counselling and supervision were interviewed, using a semi-structured questionnaire. The interviews were analysed using the 'constant comparative method'. They revealed that the participants would not use the term 'clinical responsibility' to describe their responsibilities. There were mixed views about the nature of the responsibility of the supervisor when supervising counsellors practising independently. The participants indicated a preference to supervise only the most experienced counsellors, with whose practice they were already familiar and in whose work they already had considerable confidence. None of the supervisors interviewed considered themselves to be legally responsible for the counsellors' work. All the participants were aware that the risks associated with counselling in private practice could be considerable and had an acute sense of responsibility for the content of the work. Reluctance to take action against supervisees who were in breach of the code of ethics was expressed. There was scepticism about the requirement for them to have supervision for their supervisory work. Implications for the practice of counselling supervision and for the profession are discussed.     

Shifting landscapes of counselling identities in Aotearoa New Zealand

ABSTRACT

The professional identity of counsellors and guidance practitioners in Aotearoa New Zealand is currently under review as a result of the passing of legislation regulating health professionals and the proposed introduction of national registration of counsellors. In this paper I explore this debate, and examine the professional identities claimed by counsellors, counselling psychologists and psychotherapists. The current discussion in this country is both informed by and provides an illuminating lens on professional identity issues in Australia, the UK and the US. An alternative construction of professional identities that are localised and dynamic, yet distinctly of Aotearoa New Zealand, is proposed.     

Young people’s perceptions of fat counsellors: “How can THAT help me?”

ABSTRACT

Being fat is widely recognised as a stigmatised identity which disproportionately impacts women, both personally and professionally. Women are numerically dominant as therapy practitioners, and we use this group to explore the ways a “fat counsellor” is imagined in the context of counselling. A qualitative story completion task, about a woman starting therapy, was presented to 203 British young people ages 15–24. Participants were 75% female, 88% white, 93% heterosexual, and 98% able-bodied. The story stem did not specify the sex of the counsellor, who was identified as fat; the vast majority of stories assumed the counsellor was female. Overall, fatness was perceived as negatively affecting therapy and the counsellor’s professional credibility because fatness was equated with a lack of psychological health, which rendered fat counsellors professionally “unfit.” This finding extends the literature on “weight bias” in professional settings and has implications for counsellors of all body sizes.     

How effective are minimally trained/experienced volunteer mental health counsellors? Evaluation of CORE outcome data

Background: Existing research findings indicate that minimally trained/experienced paraprofessional counsellors can be as effective as professionally trained and experienced counsellors. More research into the effectiveness of paraprofessionals with specific client populations is required to determine the conditions under which they can be most effective. Aims: To evaluate the effectiveness of a group of 12 minimally trained/experienced volunteer mental health counsellors. Method: Data were collected over a one year period on 118 clients referred to a voluntary sector counselling agency. The CORE-OM was used to measure clients' levels of distress on a session-by-session basis. Clients and counsellors also completed a range of additional self-report measures. A benchmarking strategy was used to evaluate the outcomes achieved by participants in this study against three benchmark studies selected from published literature. Results: Paraprofessionals in this study were less effective than their professional counterparts. Results showed that participants in this study achieved an effect size of .70 compared to effect sizes of 1.36, 1.39 and 1.42 in the selected benchmark studies. Implications: Findings suggest that minimally trained/experienced paraprofessional counsellors working in mental health settings may benefit from longer and more targeted training programmes before engaging in practice. Conclusions: The benchmarking strategy provided a valuable and practical means of evaluating the comparative effectiveness of paraprofessional and professional counsellors. Findings should be interpreted cautiously as the selected benchmarks are not precise measurements and may not reflect the organisational factors operating within voluntary sector counselling agencies.     

Supervision and career counsellors: a little-explored practice with an uncertain future

While the supervision of counsellors has received much attention in the literature, there is a dearth of empirical and conceptual literature about the supervision of career counsellors. Career counselling has not to date followed other helping professions towards increased requirements for supervision or compulsory supervision. Recently there has been slight evidence of change and some advocacy of supervision for career counsellors in the literature. However, no previous studies related to supervision and career counsellors have been conducted. The Australian study reported here gathered information from members of a professional career counselling association about supervision through survey and focus group interviews. The findings revealed that supervision is not widely practised and that there are varying levels of understanding of and commitment to supervision.     

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.     

Counselling young people: Counsellors' perspectives on ‘what works’ – An exploratory study

Aim: Counsellors who work with young people in a range of contexts know that they are not engaging with ‘mini‐adults’. The issues young people bring to counselling are often complex, challenging and wide‐ranging, as adolescents are experiencing times of turbulence and change in their physical, emotional, social and psychological development. This paper focuses on a research project undertaken with five counsellors who work with young people, and asks the question: ‘What works?’ Method: The research project is an in‐depth qualitative study into the counsellor's experience of counselling young people, using a narrative approach. Findings: Four key shared themes emerged: the significance of ‘safety’ in the relationship; building the therapeutic alliance; flexibility and integration relating to theoretical orientation; and the use of creativity. Outcomes: This paper offers counsellors the opportunity to reflect on ‘what works’ and consider the professional knowledge, which underpins their own counselling practice with young people.     

An exploration of the experience of Christian counsellors in their work with both Christian and non‐Christian clients,with particular reference to aspects of cultural transition

Aim: This study explores the experience of Christian counsellors working in both Christian and secular settings, paying particular attention to the possibility of regarding their development as a form of cultural transition. Method: Heuristic methodology was used, interviewing 22 counsellors with varying churchmanship (i.e. Christian tradition/denomination) and counselling training. Findings/Discussion: A spectrum of experiences with both Christian and non‐Christian clients emerged. The level of overtness of the counsellors’ faith with these clients varied considerably. Parallels with the experience of these counsellors and that of immigrants in terms of cultural transition are discussed. Conclusions: The experience of Christian counsellors differs with respect to the level of Christian influence (i.e. Christian or secular input) in training, supervision and work context. Those with higher secular influence have less difficulty working with clients with different belief systems and values. Implications: Christian counsellors need to be more reflexive with respect to the effect of their own value systems when working with clients, particularly if they work mostly in a Christian context. Trainers need to be aware of cultural transition aspects in the development of counsellors who have a Christian faith.     

The student counsellor as a team member

Describing the future roles and services of British counsellors in higher and further education must not be done in professional isolation. We need to consider how the future roles of professional counsellors will positively affect the counselling done by academic staff Furthermore, rather than making generalisations about counselling needs, it may be better for working parties or task forces to develop counselling models which are appropriate to particular institutions. Such task forces should address some of the pressing issues confronting academic institutions: for example, (1) the revitalisation of the curriculum; (2) the improvement of the out-of-classroom relationships between academic staff and students; and (3) the development and maintenance of effective systems of academic government. If counsellors are to develop services which will help to resolve some of the problems associated with these issues, they will have to be increasingly clear about their own values.     

Counselling Supervision: The British context

Counselling/psychotherapy supervision is on the verge of a professional breakthrough in Britain today. Training courses are emerging, accreditation for supervisors is in progress and a Code of Ethics for Supervisors is finalised. Yet supervision is still little understood. There are few agreed definitions and certainly no agreed tasks, roles, or even goals of supervision. Conflict still abounds about whether it is more akin to therapy than to education, about whether or not it shold be evaluative, and about what areas of counselling it should cover. Supervisors are poorly trained in supervision and areas such as the legal implications and responsibilities of supervision not clear and often not even considered important. What research has been done is confined largely to United States and few attempts have been made to apply findings to Britain, e.g. how valid in Britain is the current research on Developmental Models of supervision which outline the stages through which counsellors in training travel.

Supervision is still tied to counselling theory despite its efforts to become a discipline on its own. Most supervisors in Britain seem to apply their theory of counselling to supervision setting. However, some of the conflicts are being faced and some questions raised about the future of supervision, about the kind of relationship involved, about its relationship to counselling. This article raises some current issues in the field and asks the kinds of questions that need answering before we are able to talk about a British understanding and application of counselling supervision.     

Student counsellors’ experiences of mindfulness as a component of their person-centred counselling training: An interpretative phenomenological analysis

Aim

Mindfulness is increasingly integrated into counselling and psychotherapy practices, as well as being introduced to students in academic institutes with the aim of supporting them to balance the responsibilities of academic study, placements and other commitments alongside university life. Despite mindfulness routinely finding its way into counselling settings and being incorporated into counsellor training, there has yet to be any research conducted to explore the experience of student counsellors who have received mindfulness as a part of their undergraduate person-centred training. This study explored the reflections of counsellors who had attended a mindfulness module during the first year of a counselling degree.

Design

Six students completing a university-based undergraduate degree in Counselling and Psychotherapy in the North-West of England, in the UK, participated in the research. The study consisted of two students from each of the three years of the programme. Participants individually attended a semi-structured interview to explore their experiences of mindfulness as a mandatory module of their training in person-centred counselling. Interpretative phenomenological analysis (IPA) was used to analyse the generated data.

Findings

Four superordinate themes were generated: 1) becoming a counsellor, 2) person-centred mindfulness, 3) time, and 4) learning and development.

Discussion

Experiential themes were explored including the process of professionalism, vulnerability, embodiment of person-centred theory and the core conditions and the conflict of approach.

Conclusion

Recommendations are made for mindfulness to be included in counselling training programmes with a person-centred focus. Suggestions for further research include longitudinal studies to follow the development of trainees over time.     

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.     

Private work in public places: Confidentiality and role tensions in a university counselling service

This paper aims to explore issues of confidentiality relating to working with undergraduate and postgraduate students in a university counselling service. The context of a counselling service within our institute of higher education has to be understood in its relationship to academic, administrative and managerial staff, to medical and psychiatric services personnel and to the wide range of other student support and welfare services in the organization whether run by university staff or the students' union. Some reflection will be given to the need for clarity in the range of roles counsellors have to play within the different functions of the university. The client-counselling relationship cannot be seen as a dyad but as a triad or an even more complex constellation of relationships when regarded in an institutional context. The central premise is based on understanding the conscious and unconscious dynamics in the institution and how these impinge on the relationship between client and counsellor in challenging or assuming the confidentiality held by the service. Such boundary issues are identified in consultation and referral, breaking confidentiality, referral of disruptive students, calls for help and holding confidentiality. The case material drawn on to illustrate these five areas is also described in terms of anxieties raised and how these are projected, introjected and contained.

Within the service client and counsellor contract to work together. It is made clear that counselling is a professional relationship with agreed boundaries and a commitment to confidentiality. This is crucial to the working relationship and is a means of providing the client with both safety and privacy. Any limitation on the degree of confidentiality offered may reduce the usefulness of counselling. Bound by his or her professional code of ethics the counsellor will reach an agreement with the client at the outset about the extent of confidentiality they are offering, take care not to disclose information given in confidence and, when possible, be able to negotiate any change in agreement with the client.

Exceptional circumstances which may occur and give rise to the counsellor's decision to break the confidentiality formerly agreed between him or herself and the client are those which give grounds for believing the client will cause serious harm to others or themselves or have harm caused to them. Reference will be made to the role of consultant supervision in such situations and how any breaking of confidentiality can best be minimized. Attention will be given to the relevant ethical codes to which counsellors adhere and the issues of confidentiality within the legal process as well as whether the requirements of providing counselling services for students in higher education impel us, logically and practically, towards certain policies in regard to boundaries.     

Counsellors' experiences of working with suicidal clients: An exploratory study

Counselling is increasingly available in a wide variety of contexts, including mental health and psychiatric services. As a consequence, counsellors increasingly work with clients who present with suicidal ideation, expressing either suicidal thought and/or intent in the counselling session. This paper describes an exploratory study that examined the experience of counsellors when working with suicidal clients. The paper considers counsellors' behavioural, cognitive and emotional responses to such suicidal expression, both on a personal and professional level. The research employed semi‐structured interviews. A constant comparative method was used in analysing the transcribed interview text. Results suggest that counsellors experience a range of responses when their clients express suicidal thought, including fear, anxiety, anger and professional impotence. The interviewees also expressed self‐doubts about their professional competence. In addition, they identified the threat of litigation for negligent practice and the lack of confidence in appropriate risk assessment approaches as significant causes for concern. The implications for further research, and practice, are discussed.     

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.     

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.     

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.