Oppression within the counselling room

This paper suggests that the oppression experienced by disabled people in society is sometimes replayed in the counselling room by counsellors who are unaware of their own disablist attitudes and prejudices. Whilst the provision of Disability Equality Training (DET) within counselling courses would ameliorate the problem, I believe that disabled people would be most empowered by a counselling approach which recognises the potential for oppression within the counsellor‐client relationship. One solution may be the creation of a new counselling approach (disability counselling) which includes the social model of disability as one of the foundations. An alternative solution may be found within the emerging counselling approaches that treat counselling as a social and political process and place emphasis on developing comprehensive anti‐discriminatory practice.     

Motivation as a predictor of outcomes in school‐based humanistic counselling

Background: Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school‐based counselling services. Aims: To assess the relationship between young people's motivation for counselling and its effectiveness within a secondary school setting. Sample: Eighty‐one young people (12–17 years old) who attended school‐based humanistic counselling services in Scotland. Method: Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Results: Motivation for counselling was not found to be significantly related to outcomes. Discussion: The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non‐significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects.     

Psychotherapy in the United Kingdom: past, present and future

The 20th century, perhaps 'the age of Freud', has seen the development and growth of psychological therapies. The first half of the century was virtually the province of the psychoanalytic approaches, with the last three decades marking the flowering of many other approaches, and a gradual and general rapprochement between nearly all the major therapies. This history is traced, identifying the major players, including behaviour therapy and humanistic therapies challenging the initially dominant model. The rapid expansion in practitioners and training courses has led to questions of organisation, registration, and relationship between the therapies. The development of UKCP and BCP is examined, examining the size of the constituent elements within these major groupings, their relationship to each other and to counselling and the Independent Practitioners Network. Other developments such as psychotherapeutic studies within universities and the subsequent linking of some psychotherapy trainings to academic qualifications are referred to, while the relationship of British psychotherapy to the European and world scene is briefly described before the author hazards a prediction that it is integrative psychotherapy that will probably expand most in the new century, with counselling asserting its right to be an equal partner in the therapeutic endeavour.     

The relationship between integrative and Islamic counselling

Integrative counselling is a valuable tool. However, it only considers the client within a social and natural framework. Islamic counselling on the other hand, utilizes the major tenets of integrative counselling, but adds to them an added dimension. This is the relationship between the client and his/her creator. In this paper I aim to draw out areas of commonality between integrative and Islamic counselling and highlight the main difference between these two therapeutic approaches.     

A qualitative investigation into the online counselling relationship: To meet or not to meet,that is the question

Background and aim: Online counselling, as a psychotherapeutic approach, provokes debate amongst practitioners and researchers concerning its efficacy and validity. This reflexive study extends existing research into the nature of the online counselling relationship when it is conducted asynchronously (by email) and explores the possibility this approach may facilitate both online and face‐to‐face therapeutic engagement. Method: Semi‐structured interviews were conducted electronically with ten former email counselling clients of a university counselling service and six counsellors delivering email counselling in other higher education settings, to explore, in depth, their experiences of the online therapeutic relationship and its impact on the counselling process and outcomes. These were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Four areas of focus emerged relating to: (1) the importance of the structure and processes involved; (2) their impact on thinking and feeling; (3) their impact on self and relationships (within and outside counselling), and (4) changes that followed email counselling. Having ‘time to think’ within the asynchronous exchanges, the anonymity and disinhibition afforded by the online medium, the creation of transitional space and the rich use of metaphor, visualisation and imagery all contributed to a sense of empowerment and relational depth for individuals who might have otherwise avoided seeking help. This led to positive change in many cases and for some, facilitated subsequent face‐to‐face counselling. Implications: The findings support the provision of counselling and therapy online and particularly its integration within existing face‐to‐face services.     

Gay men's experiences of therapy

Fourteen gay men were interviewed using a structured interview schedule to explore their experiences of being in therapy. Particular importance was given to their perceptions of how their sexual orientation impinged on the counselling process and how their assumptions about counsellor sexual orientation affected the therapeutic relationship. The limitations of using structured interviews in qualitative research are acknowledged. Some significant findings were made, which were not well documented in the literature, such as the impact on the therapeutic relationship of internalised homophobia within gay men themselves. These findings hold the potential to inform counselling practice with gay male clients. Recommendations are made in relation to both practice and further research.     

Evaluating the therapeutic use of photocards in European prisons

This paper focuses on the evaluation of the therapeutic use of photocards by prisoners and facilitators in a counselling psychology led European project, based on responses to open-ended questionnaires. It is part of a wider project, involving seven partner organisations in six European countries (England, Finland, Greece, Italy, Malta and Romania), which developed and trialled four different approaches to using photography in the context of counselling in prisons. Of the 51 inmates that participated in the project, 48 (94%) completed the questionnaires; of those, 39 (77%) were available for individual analysis due to prison restrictions in one partner organisation only allowing group data. Of those 39, who returned their completed questionnaires, over 92% found the therapeutic use of photographs either very helpful (56.4%) or helpful (35.9%), and the remaining 7.7% described it as average. From the thematic analysis, main themes emerging regarding inmates’ experiences of working with photocards were that it: facilitates emotional expression and sharing; unlocks memories and reconnects with life outside; fosters insight, reflection and self-growth; breaks the monotony of prison life and, overall aids emotional learning. A thematic analysis of 11 psychological therapists/facilitators’ perspectives showed that the use of photocards: gives clients a voice; provides a safe and collaborative frame and a therapeutic relationship; and, provides a useful icebreaker, helpfully overcoming anxieties of both client and psychotherapist/facilitator. Overall, photocards were considered useful as their projective nature can help facilitate prisoners’ strong need for expression in a context where there are limited opportunities and trust is fragile.     

Counselling — Why not? A qualitative study of people's accounts of not taking up counselling appointments

The aim of this research was to explore the reasons behind people's decision not to take up a counselling referral. A qualitative study was carried out, using semi‐structured interviews and written responses. The investigation was based in NHS primary care counselling services in a GP practice in the North of England. People who had been referred for counselling by their GP, but did not attend any counselling appointments, were interviewed or invited to submit written comments. Many people talked about the courage it took to ask for help. The referral itself was sometimes therapeutic as it legitimised their distress. The GP's response affected people's decisions. Waiting time and what happened during waiting was important. Some people had their own resources, which they used actively, seeking other sources of help; others were more passive, their lives changed around them. Other factors that contributed to non‐engagement were being referred in a crisis; lack of knowledge about counselling and mental distress; and concern about stigma and its impact on work. Perceived waiting time was the most significant factor for participants in this study, but most people had a combination of reasons for not engaging. Support from the GP, information about the service and being given a realistic expectation of waiting times, may help people feel better able to access counselling services.     

Clients talk about their experience of the process of counselling

The purpose of this study was to ascertain clients’ experiences of their counselling. This was done through use of a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in agency located in a mid-sized city in New Zealand. Several themes were identified and discussed in relation to the literature on clients’ perceptions of their own counselling. Specifically, clients were asked to comment on whether their counselling was effective, how much of their improvement was due to counselling versus other factors, the quality of the relationship with their counsellor, specific in-counselling events that were helpful or unhelpful, and how their counselling was terminated. Implications for practice were suggested.     

Gender and Educational Guidance: Questions of Feminist Practice

Questions are raised about gender in relation to educational guidance and counselling, considered as a broad family of practices, largely within the liberal humanist tradition. Three fields of study with substantial feminist contributions are suggested as potentially relevant: discourse theory; research on curriculum construction; and therapeutic counselling. Of these, discourse theory is the most problematic. Feminist approaches to curriculum are distinguished as reconstruction, incrementalism, and radical transformation. In the area of therapeutic counselling, significant work includes feminist psychology, the examination of counselling as gendered practice, and single-sex groups. Each of the three fields of study is discussed, and questions and implications for guidance are identified. Ways towards a more thoroughly gendered approach to guidance are suggested.     

The effectiveness of university counselling for improving academic outcomes and well-being

The work discusses the effectiveness of the counselling treatment to enhance student academic success. The participants were randomly assigned to either an experimental group (66 students who had completed counselling treatment) or a wait-list comparison group (44 students). The Adult Self Report (ASR) by Achenbach and Rescorla [2003. Manual for the ASEBA adult forms & profiles. Burlington, VT: Research Center for Children, Youth, & Families, University of Vermont] and the Outcome Questionnaire 45 (OQ-45) by Lambert and Hill [1994. Assessing psychotherapy outcomes and processes. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 72–113). New York: John Wiley] were applied before and after the counselling sessions. Data show statistically significant decrease in the ASR clinical scales for both internalising and externalising problems after counselling as well as in the OQ-45 scores for distress symptoms and relationship difficulties. Compared with the control group, the students who received counselling exhibited a significant recovery regarding their progress with their studies.     

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.     

How common is sexual attraction towards clients? The experiences of sexual attraction of counselling psychologists toward their clients and its impact on the therapeutic process

This study investigated counselling psychologists' experiences of sexual attraction to their clients. Self-reported incidence of this phenomenon, the reaction that it provokes in therapists, the way they manage their feelings, and the potential impact of their sexual attraction on the therapeutic process, were assessed. On the basis of previous studies of psychotherapists, it was hypothesized that sexual attraction toward clients is common, and that these perceived feelings are not necessarily negative to the therapeutic process or professional relationship; also, it was hypothesized that the disclosure of these feelings to the client could nevertheless lead to a positive therapeutic outcome. Questionnaires were sent to the 286 chartered counselling psychologists included in the British Psychological Society Register. The results showed that significantly more therapists were attracted to at least one client than not. Furthermore, half of the respondents who reported attraction to clients believed that their feelings had a positive impact on the therapeutic process. Therapists who had disclosed their feelings to their clients found significantly more frequently that the impact of their sexual attraction had been positive to the therapeutic process (87.5%), than therapists who did not disclose their sexual attraction (47.1%). The implications of these results for training, supervision and professional issues are discussed.     

Counselling values and their relationships with self-efficacy among Chinese secondary school teachers in Hong Kong

Two-hundred-and-ninety-nine Chinese secondary school teachers in Hong Kong were assessed on their endorsement of counselling values using a 19-item self-report checklist, and on their perceived self-efficacy towards helping using the 10-item Schwarzer-Wegner scale. These teachers were found to share the same counselling values as counselling psychologists. They prized most highly the humanistic counsellor qualities, followed by counselling practice with a preventive, developmental and holistic perspective. Their relative endorsement of scientific values suggested that they were not resistant to the promotion of empirically supported and evidence-based treatment approaches. Teachers’ self-efficacy towards helping was also predictable from endorsing values related to interpersonal relationships and diversity in counselling practice. Implications of the findings for improved counselling training for teachers are discussed.     

Exploitation in therapy and counselling: a breach of professional standards

Exploitation in therapy and counselling may occur in only a minority of cases, but when it does, its effects are potentially damaging to both the client and the profession. Exploitation in therapy may take the form of psychological, covert and overt abuse. The most reported form of abuse of the therapeutic relationship is of a sexual nature. However, psychological abuse usually forms the backdrop to sexual exploitation, preceding and perpetuating the sexual involvement. Sexual exploitation in therapy is an abuse of the power imbued in the therapist by nature of his professional role. It allows the therapist a sexual gratification which he would not have been likely to achieve outside the therapeutic relationship. The prevention of sexual exploitation in therapy is an issue of concern to training, employing and professional organisations who seek to maintain high standards of counselling delivery. Determining the variables which may contribute to exploitation is fundamental to avoiding its incidence. This paper discusses the factors underlying the use of therapy and counselling as a medium for therapist abuse. It examines (i) the prevailing conditions for abuse to occur, (ii) how the therapist overcomes client resistance, and (iii) the implications for the maintenance of professional standards.     

Experiencing gay affirmative therapy: An exploration of clients' views of what is helpful

Gay affirmative therapy is a counselling approach that emphasises an affirming, non‐pathologising approach to therapeutic work with lesbian, gay and bisexual clients. In this study, lesbian and gay clients who had experienced counselling that they defined as affirming identified what they perceived to have been helpful. Questionnaires and interviews were used to collect the views of a sample of lesbian, gay and bisexual informants. The material gathered was analysed using a grounded theory approach, which generated six main categories: communicating a non‐pathologising perspective on homosexuality; the counselling relationship; the counselling space; what the counsellor brought to the relationship; humanity; and the counsellor adopting a holistic approach. Some of these identified affirming elements are unique to gay affirmative therapy and cannot be attributed to other factors. The possible significance of the findings for practitioners is discussed.