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.     

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.     

Family therapy ‘lite’? How family counsellors conceptualise their primary care family work

A number of current developments in the field potentially provide opportunities for preventative relationship and family interventions to be integrated into primary care. In this context, it is important to understand what family counselling is and how it might differ from family therapy. Thus, this paper investigates how the service of one low-intensity family counselling provider, Relate, is conceptualised and practised by counsellors on the ground. Questions about practice were posed to five focus groups of family counsellors and these were analysed using thematic analysis. The findings suggest that Relate family counselling is seen as ‘family therapy lite’, with a flexible, eclectic and integrative use of concepts and techniques within a systemic framework. Implications of this conceptualisation of family counselling for training, practice and research are discussed.     

Integrating counselling, psychotherapy and healing: An inquiry into counsellors and psychotherapists whose work includes healing

A qualitative study of 30 counsellors or psychotherapists whose work also includes healing was conducted using semi-structured interviews. Seven of the participants then joined the researcher in a human inquiry group. Participants in the research had been practitioners for a mean of over 10 years. The main themes that emerged were: the transition by the practitioner towards the use of healing; the taboo concerning talking about spiritual and healing experiences reported by the participants; the nature of healing as distinct from therapy; the supervision difficulties that arose when participants engaged in both counselling/psychotherapy and healing with their clients; and the concept of spiritual space. Some very experienced psychotherapists and counsellors are now including healing in their work. This raises a number of important issues, particularly relating to supervision.     

Marriage Counsellors’ Reflections on the Counselling Process in Family Courts in India

Family courts in India were established to facilitate speedy redressal of family disputes, particularly matrimonial issues. Marriage counsellors facilitated dispute resolution based on alternative dispute resolution practices. Counselling was mandated for all couples approaching family courts due to marital discord. At present, there is a lack of literature on the process of counselling followed by marriage counsellors in the family courts. The present study used an exploratory research design to understand marriage counsellors’ perspectives on the process of counselling in family courts. Fifty-six marriage counsellors completed open-ended questionnaires on counselling assessment, goals, interventions and the influence of the presence of children on the couple counselling process. Thematic text analysis of the responses revealed a range of areas that counsellors explored, individual and relational goals that they focused on, as well as the interventions used by marriage counsellors in their work with couples. Findings suggested that there was a lack of uniformity in the counselling approaches used by marriage counsellors. Additionally, marriage counsellors reported not being equipped to address some intrapersonal and interpersonal concerns that emerged in the counselling process, despite identifying them. Based on the findings, the paper recommends the need for a unifying framework for training and practice for marriage counsellors working with couples in family courts to conceptualise couples’ concerns as well as guide their goals and interventions. The paper underscores the need for acknowledging sociocultural influences, reflective practice and client feedback in the process of counselling.     

Research into the organisation,training and effectiveness of counsellors who work for free

The activities of voluntary or ‘paraprofessional’ counsellors, who work for free, represent a highly significant component of the delivery of psychological therapy in Britain and other countries. However, in recent years there has been relatively little published research into issues associated with the provision of service by counsellors who work on a voluntary part‐time basis, and who typically receive limited training and supervision. This paper introduces a special theme section on counselling in the voluntary sector, which highlights some recent examples of research into the context, organisation, training and effectiveness of such counsellors. Some suggestions are made concerning the research agenda for counselling in the voluntary sector.     

Counselling Psychologists and Counsellors: New Challenges and Opportunities

The next three or four years are likely to see the emergence of a new professionally recognised group of British counsellors. They will be known as counselling psychologists. The developments that will lead to the establishment of this new professional group are outlined and some of the ways in which counsellors and counselling psychologists may complement each other's work are examined. Some anxieties are voiced about how overlapping professional boundaries might produce friction between the two groups, and a few ideas about how this may be avoided or minimised are suggested.     

The impact of Christian counselling on survivors of sexual abuse

The absence of research and growing involvement of Christians in all areas of counselling gave rise to this study which explores the impact of Christian counselling on adult survivors of sexual abuse. The sample of 44 women and 5 men from an inter-denominational, self-help network, completed a self-report questionnaire of perceived Christian and professional counselling experiences involving issues of trust, power, directive approach, use of prayer and Scripture, responsibility and outcome. Results show that Christian counselling is experienced as qualitatively different from professional counselling: Christian counsellors are perceived as significantly more directive and more powerful than professional counsellors and the overall outcome was perceived more negatively. A number of key factors were identified which influenced the negative experience of some Christian counselling. These included having experience of professional counselling, an emphasis on the use of prayer and Scripture, perceiving the counsellor to have different goals from the client, feeling blamed for continued distress and having prior experience of prayer ministry. Implications for counselling practice and training are discussed.     

The experience of working with refugees: counsellors in primary care

The provision of counselling services for refugee and asylum-seeking patients is relatively new in the UK and their complex needs may present considerable challenges within primary care, where access to specialist support resources is often limited. As far as we know, no previous research has attempted to look at the experiences of the counsellors who do this work. We undertook in-depth interviews with 13 counsellors who provide counselling to refugees in primary care in north London. The findings of this study suggest that counsellors who work in a primary care setting find themselves conflicted, troubled and out of their depth by the experiences, narratives and distress presented by refugee and asylum-seeking patients. They also report an erosion of usual counselling boundaries. Thus, the problems presented by refugees seem to demand approaches which go beyond standard counselling practice and which create ambivalence and uncertainty. These counsellors express feelings of isolation and impotence. The paper concludes with implications for counselling practice and suggestions for further research.     

A feasibility study of the systematic evaluation of client outcomes in a voluntary sector counselling agency

There is an increasing demand on voluntary sector counselling agencies to evaluate the effectiveness of their work with clients. A pilot study was carried out in a voluntary sector counselling agency to assess the feasibility of adopting a well‐established evaluation system (CORE) designed to measure client outcomes. The paper describes the issues and complexities involved in introducing such a system, and explores the impact of the evaluation on counsellors, staff and users of the service. It is suggested that evaluation can play an important role within voluntary organisations in enabling counsellors and staff to reflect on their work.     

Spiritual Dimensions in Counselling: Editor's Introduction

Contributors to the symposium experienced difficulty in finding appropriate language to express their understanding of spirituality and the essential nature of their work with clients. Nevertheless, a fascinating world emerges from which it is clear that many counsellors are now fulfilling the role of spiritual companion. The implications of this for therapists in general are examined, as well as what it means for clients to conceive of themselves as 'spirit'. The question of whether or not counsellors are taking over from the clergy as spiritual guides is explored.     

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.     

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.     

Cancer counselling in the United Kingdom

Abstract

A national survey of 289 people from a variety of professions (nurses, social workers, clinical psychologists, psychiatrists, etc) involved in counselling cancer patients and their families within the United Kingdom obtained a response rate of 82%. The primary findings discussed in this paper cover a range of issues, including the working conditions and responsibilities of the counsellors, what professional qualifications they possess, the extent and availability of supervision and support, as well as the types of counselling intervention employed. Particularly disturbing was the fact that only 25% of our sample had any recognised formal counselling qualification and that 75% did not belong to any professional counselling organisation. In view of the wide diversity of qualifications, salary scales, responsibilities and working conditions and practices amongst the respondents, we propose that the National Health Service (NHS) should establish clearer guidelines as to the minimum acceptable qualifications for people employed as oncology counsellors, and that more adequate provision and resources are made available for training and supervision.     

Counselling and primary prevention

Counsellors and counselling services are frequently involved in primary prevention work. Increasingly these services are required to help immediately after major disasters, an implicit assumption being made that normal social support networks will be unable to cope. A review of the literature suggests extensive participation of counsellors in primary prevention activities despite difficulties in definition, training and funding, and evidence that some interventions may be ineffective or harmful. It is suggested that counsellors providing primary prevention services should be aware of the complex practice and philosophy issues surrounding such efforts, and should be rigorous in assessing the real effects of primary prevention activity.     

Counselling older adults: Issues and awareness

This paper explores understanding and awareness among counsellors and counselling psychologists, of work with older people. The result of a piece of reasarch on this topic are presented. These tentatively confirm a relative lack of interest and insight into work with this age group and indicate that an age bias may exist among therapists. The reasons for this lack of awareness are explored and it is suggested that issue of the therapists' countertransference is crucial and that work with older persons may raise complex emotional issues for the counsellor. Possible future directions for research are discussed.     

Spontaneous Self‐Practice of Cognitive Behavioural Therapy (CBT) by Aboriginal Counsellors During and Following CBT Training: A Retrospective Analysis of Facilitating Conditions and Impact

Previous cognitive behavioural therapy (CBT) training studies have suggested that therapists who practice CBT strategies on themselves during training may experience professional and personal benefits. However, it has also been reported that some CBT trainees are reluctant to engage in self‐practice. The present study reports an incidental finding from a CBT training study with Aboriginal counsellors: all five counsellors reported that they practiced CBT techniques on themselves without specific encouragement by the trainers to do so. This paper therefore posed three questions: (a) Why—in contrast to some other trainees—did this group choose to apply CBT to themselves? (b) How did they apply it—with what purpose, in what contexts, and which skills? (c) What was the impact of CBT self‐practice? Data from the group's reflections were qualitatively analysed by two of the researchers, and “member checked” by the remainder. Results indicated that the counsellors were motivated to practice CBT on themselves for two principal reasons: the value they placed on CBT, and their personal need resulting from the high number of crises experienced while living and working in their communities. The counsellors reported practicing CBT in a wide variety of contexts as part of their learning. As in previous studies, the impact of CBT self‐practice was that it increased their confidence and competence as therapists. It also appeared to be a valuable burnout prevention strategy. If the results are generalisable, they suggest that self‐experiential training in CBT may be a culturally responsive and adaptive way for Aboriginal counsellors to enhance their learning of CBT skills.     

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.     

“Bridging the Gap”: A reflexive thematic analysis of the experiences of therapy trainees transitioning from psychodynamic counselling to cognitive behavioural therapy

There is limited empirical research and insight into the experiences of therapy trainees who are being taught more than one psychotherapeutic approach during their training. Further understanding is warranted to ensure that a dual modality approach to training (that is, where therapists are trained in two paradigmatically distinct modalities) is experienced as worthwhile and acceptable to trainees and to better understand any challenges faced when transitioning between approaches. The aim of this study was to investigate trainees' experiences of transitioning from psychodynamic counselling to cognitive behavioural therapy (CBT) on a two-year master's degree that offers a dual modality approach to training. Data were collected from a sample of 8 trainees using an online semistructured questionnaire. These data were analysed using Braun and Clarke's (2020) reflexive thematic analysis. Four main themes were identified: (1) perceived competence; (2) preparedness; (3) professional advantages; and (4) external challenges. The findings suggested considerable individual variation in the ease with which participants navigated the transition between therapeutic modalities. Those who found the transition easier used the structure of CBT to provide a framework and point of difference that allowed them to temporarily suspend their psychodynamic learning in order to embrace a new therapeutic approach. Others experienced the move to CBT as posing a threat to their developing identities as counsellors. Recommendations are made on how to prepare trainees for the transition including exploring the psychological impact of transitions, increasing opportunities for reflective practice and facilitating exploration of what it means to be a therapist trained in two distinct therapeutic modalities.