Post-traumatic stress disorder (PTSD): A rational emotive behavioral theory

The PTSD Theory and practice of rational emotive behavior therapy (REBT) is explained and compared with other forms of cognitive behavior therapy (CBT) that help clients to dispute their dysfunctional cognitive processing and to use exposure. Because these other CBT Theoreries do not emphasize REBT's principles of absolutist musts and demands it is shown how REBT hypotheses may better explain some of the cognitive processing theories of other CBT formulations regarding PTSD.     

A multiple case study approach to work stress prevention in Europe

Work stress has become a major issue among European employees. The current practice of its prevention seems disappointing, as work stress prevention programmes are predominantly reactive and biased to the individual. The lack of organization-level intervention studies is a barrier to progress in reducing work-related stress. In addition to the “true experimental approach”, multiple case studies may provide an adequate research strategy for addressing the potential impact of stress interventions in organizations. The study aim was to obtain more knowledge with respect to evidence-based work stress prevention in Europe, by focusing on both content (cause-effect relationships) and process (“how”). Therefore it was decided: (1) to collect from each European Union member state a work stress intervention study; (2) to analyse each of these cases as to content and process factors; and (3) to systematically compare these studies in a step-by-step approach. Through a network approach, 11 cases were identified. Nine projects received an acceptable methodological standard and were included in this study. Evaluation of these cases reveals that stress prevention is no “one time event”, nor merely a technical process. It is concluded that “true prevention” (i.e., preventive measures that are based on an adequate diagnosis identifying risk factors and risk groups, which theoretically and logically fit in with the problems, and which are introduced and implemented in a proper way) may be beneficial to both the employee and the organization.     

Some thoughts about a scientist-practitioner approach to assessment training in counselling psychology

Training effective scientist-practitioners has long been an issue of concern in counselling psychology. In a recent paper, Friedlander (1992) developed a useful prototype to foster science-practice integration in a counselling seminar. Drawing on Friedlander's prototype, the question of “how to foster science-practice integration in assessment” is considered. Some assessment reading lists and class exercises designed to illustrate such integration are proposed. These teaching materials are presented: (a) in hopes that they might prove useful for some assessment instruction purposes; and (6) in hopes that they might stimulate further thinking about how to best foster science-practice integration in counselling psychology assessment courses.     

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 nature of irrational and rational beliefs: Progress in rational emotive behavior theory

This paper discusses some limitations of Ellis's Rational Emotive Behavior Therapy. It is suggested that the present definition of irrational and rational beliefs is inadequate. The present theory is unclear whether irrational beliefs are exaggerated negative evaluations or empirical distortions of reality. It is proposed that irrational beliefs are core schemes, and that the concept of schema replace the present definition of beliefs. Ellis's position that demandingness is at the center of irrational thinking and emotional disturbance is examined. Research has failed to support this theory. It is proposed that demandingness and self-downing may be separate types of core irrational schemes. Research strategies are suggested that could test Ellis's position on the centrality of demandingness and on the nature of irrational beliefs in general.It is also suggested that irrational beliefs differ on their level of abstraction. The present REBT theory fails to identify which level of abstraction is necessary to cause disturbance, at which level of abstraction therapists should seek change, and whether a therapist should intervene first at higher or lower levels of abstract beliefs. It is suggested that a therapist only seek change to the level of abstraction that matches the client's concerns and that therapists begin to intervene at lower levels of abstraction and move up to more abstract cognitions as therapy progresses.The Institute for Rational Emotive Therapy     

Certainty and uncertainty in genetic counselling: a qualitative case study

This study examines the communication that occurs during routine genetic counselling sessions. It involves the qualitative analysis of nine consultations with one member of a clinical genetics team. The consultations were characterised by a contrast between the sense of certainty apparent in how the clinicians talked about the power and promise of the new genetics and the uncertainty communicated regarding the actual information produced by genetic tests and their limitations in solving people's problems. There was also a contrast between how the clinician seemed to control the format and agenda of the consultation and the apparently uncontrollable personal and social implications of the topics discussed. We speculate that this may be explained in terms of the clinician giving some order and certainty in an area of inherent uncertainty, and where great promises are as yet unrealised.     

Introducing counselling in secondary schools: A case study with reference to frame issues

Abstract

I am a deputy headteacher in a comprehensive school. I believe that the widespread re-introduction of counselling into secondary schools offers possibilities for great benefit, both in terms of the personal well-being and emotional health of students, and also in terms of academic results and other educational indicators. It is my view that, currently, this may particularly be true for boys.

This paper is a double case study: first, of the failure of a student to cope with ordinary schooling because of his emotional difficulties; and, second, of the establishment of a counselling service which resulted from his permanent exclusion from the school.

I allude to some of the theoretical issues which meshed with the practical details of establishing the counselling service, and offer some tentative conclusions about the rationale for counselling in secondary schools and the kind of model which seems most likely to be beneficial.     

A behavioural and systems approach to family therapy: a position paper

An integrated model of a behavioural and systems approach to family therapy is presented, the main premise being that family interactions are affected by reciprocal determination of cognitions, feelings and behaviours in relation to the environment. Assessment involves a systematic exploration of the interaction and transactional patterns within the family, and the identification of the dysfunctional aspects of such patterns. The main aim of the intervention is to produce change in family behaviour by addressing the important cognitive and affective issues. This entails techniques such as cognitive restructuring, social modelling and operant conditioning which can be used separately, in parallel, or in combination. Whether one or more of these techniques is used depends on the nature of the family's problems and the aims of treatment.     

Counselling, counselling skills and encouraging pupils to talk: Clarifying and addressing confusion

The context in which counselling approaches operate in schools is outlined. The issues that arise from the location of counselling skills and the practice of counselling in the framework of pastoral care and of personal and social education are discussed both from a historical perspective and in terms of the current educational climate. Ways in which counselling and counselling skills might be more appropriately and effectively used in schools are considered.     

Counselling with a profoundly deaf client and the impact of a therapist's dream: A case study

This case study explores the experience of one client participating in a project evaluating the use of dreams in short‐term counselling within the National Health Service. The client received 24 sessions of counselling and completed a post‐counselling semi‐structured questionnaire. This was followed by a semi‐structured interview, which confirmed the internal coherence within the participant's narrative and allowed a more detailed exploration of her experiences, supported by process notes. Supervision challenged the therapist's preconceptions and held her in her uncertainty until the work was aided by a dream that the therapist had of the client.     

Action and language: Contextual action theory in counselling

Contextual action theory is presented as a conceptual framework useful for grounding the recent work in counselling and career development called Life Design. Based on the premise of the goal-directed nature of human action, this approach has links to language in theories of naive action and attribution, and theory of mind. Contextual action theory has an associated research method that has been used to generate a range of research studies that have described actions and projects in the career development and counselling domains. The link that contextual action theory provides between research and practice allows the identification of five tasks for the counselling practitioner informed by this approach.     

Action: a bridge between vocational and mental health counselling*

A theory of goal-directed action is proposed as a conceptual link between vocational and mental health counselling. Originally emerging from the vocational counselling field, contextual action theory is presented as a critical conceptual link not only between mental health and occupational life but also between counselling practices in these domains. This specific application of goal-directed action to vocational and mental health counselling is addressed by describing counselling as goal-directed action, the five tasks of counselling it invites, and tools for supporting client goals, such as the self-confrontation interview.     

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.     

Towards networking in counselling: a follow-up study of Finnish school counselling

A follow-up study (1990-1997) and in-depth interviews on school counselling practices and problems in Finland showed that in the last 10 years the work of the school counsellor has extended and become more diversified. This article analyses this change in school counselling in terms of the problems and core tasks of counselling and the new challenges faced by Finnish counsellors, such as dismantling the traditional gender divisions in working life and counselling for immigrants. In addition, the article examines how school counsellors have attempted to solve the problems related to their work, for example, by establishing counselling networks inside and outside the school.