At the border: reflections on psychoanalytically oriented counselling in an Italian university setting

This paper analyses the ‘border’ position of counselling services in Italian universities. The concept of ‘border’ has great relevance in the work of psychoanalytically oriented university students’ counsellors. Counselling is part of a continuum of interventions, from befriending to psychotherapy. This closeness encompasses the need for identifying specificities and differences among interventions. Moreover, a university counselling service occupies a ‘marginal’ position, continuously confronted with the risks of rejection and/or assimilation. The concept of ‘border’ is also useful to define the developmental phase of university students, crossing the border between late adolescence and young adulthood, as represented by Conrad's novel The shadow line (1917/1999), recently analysed by Green (2008) as the metaphoric demarcation line between youth and adulthood. Finally, most of the students referring to our counselling service come from families that for the first time crossed the border of university education.     

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.     

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.     

Young clients' narratives of the purpose and outcome of counselling

This study explores how adolescent clients construct the purpose and outcome of counselling. A narrative analysis was performed on interviews with 22 clients (aged 16–18) who had used a school-based counselling service. The aim was to identify the purpose and outcomes that participants attributed to their counselling experience. The analysis identified four narrative forms that young clients used to describe counselling. These included ‘transformative’, ‘supportive’, ‘pragmatic’ and ‘disappointed’ narratives. Each narrative form constructed a different purpose and outcome for counselling. Engaging with clients' narratives about the purpose and intended outcome of counselling may allow counsellors to better match their expectations and approach to fit with their young client or to work with them to co-construct more flexible narratives that support helpful outcomes.     

Counselling former members of charismatic groups: considering pre-involvement variables,reasons for joining the group and corresponding values

A majority of counsellors and other health professionals who work with former members of charismatic groups appear to give little consideration to pre-involvement variables such as reasons for initially joining the group and corresponding values. This study explores reasons for joining a charismatic group from the perspective of former members through the use of qualitative methods. Seven participants from four different groups were recruited via purposive sampling and modified snowball sampling. In-depth interviews were used to explore the participants’ accounts of why they joined a charismatic group. The findings of this study suggest that participants of this study joined charismatic groups because of the ability of such groups to provide ‘certainty’ and meet needs of friendship, meaning, and belonging. The need for health professionals to consider pre-involvement variables when working with former members is discussed.     

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 counsellor and the GP: The gulf and the isthmus - or the dilemmas of difference

Research supervision in the field of counselling and psychotherapy is a fruitful area for investigation in view of the fact that the research supervisory relationship is powerful and highly charged, whether consciously acknowledged or not. Researchers trained as counsellors and psychotherapists possess the skills to facilitate the emergence of, and work creatively with, impasses and crises, both in the research itself and the supervisory relationship, as a result of their training and experience in dealing with crisis and catharsis in clinical work. This paper will demonstrate these points using a case vignette from my work as a supervisor of research dissertations undertaken by students on a Masters in Therapeutic Counselling course. Drawing on narrative analysis, clinical supervision theory and discursive analysis it will look at the strengths and weaknesses of a ‘psychotherapeutic’ approach to research supervision.     

Containment in theory and practice

Abstract

This article selects the term ‘containment’ as a vehicle for an exploration of multi-professional work and communication in the general practice setting. The term was selected because of its widespread use by and relevance to the different professionals who work in general practice. It is sufficiently elastic to be applied to one-to-one work between patients and GPs, counsellors, nurses or complementary therapists, and to a multi-professional teamwork process.

The exploration of the concept in use at Marylebone Health Centre is complicated by the multi-professional nature of the team and then-wide range of belief systems and language groups. In the process of exploring the term, members of the team had to cope with their discovery that it was being used in contradictory ways. They decided that a new and more grounded definition in shared and ordinary (nonprofessional) language was needed, if the term were to become a vehicle for inter-professional collaboration and if unhelpful, anti-task social defences were to be minimised.     

Career guidance and therapeutic counselling: sharing ‘what works’ in practice with young people

Many young people in the UK and across the world, where austerity measures are biting deep, find themselves at a time of crisis and uncertainty in their lives. The assumptions previously held of clear and straightforward career paths are being challenged and ‘career’ has come to mean more than simply ‘work’ or ‘employment’. This has implications for career practice, where career advisers are engaging with a range of complex issues in their guidance interactions with clients. This article draws on research undertaken with therapeutic counsellors into ‘what works’ when counselling young people. It offers career practitioners the opportunity to reflect on four key emerging themes and to consider how the discipline of therapeutic counselling might inform guidance practice.     

Heidegger’s Transcendental Empiricism

Heidegger’s ‘serious idealism’ aims at capturing the realist impulses of our natural consciousness whilst avoiding a collapse into metaphysical realism. This idealism is best conceived as a form of transcendental empiricism. But we need to distinguish two varieties of transcendental empiricism, corresponding to Heidegger’s early and later work. The latter, transcendental empiricism₂, is superior. Here, Heidegger’s ontology of gift gives full, conceptual shape to the two-way dependency between man and world characteristic of transcendental empiricism as a whole. In exemplary forms of inspired experience, marked by the 'animation' of our conceptually-structured natural powers, things call on us in a speech that is their very own. This moves us decisively beyond not only early Heidegger’s transcendental empiricism₁ but also the picture of experience presented in McDowell’s Mind and World.     

The relationship between personal philosophy and effectiveness in counsellors

This study investigates the relationship between the effectiveness of counsellors and their personal philosophy, beliefs and attitudes. There is a review of the relevant literature concerning the qualities and attributes of effective counsellors, with a detailed examination of studies of counsellor philosophy. Two groups (n = 14 and n = 19) of counsellors on training courses were studied. Each participant wrote an account of a ‘Helping Relationship Incident’ which was rated on the 12 dimensions of counsellor ‘perceptual organization’ developed by Combs & Soper (1963). Course tutors gave ratings of the counselling effectiveness of their students. Rank order correlations between judgements of counsellor effectiveness and ratings of perceptual organization/philosophy were made. In both groups statistically significant results were found, adding weight to the hypothesis that a ‘person-centred’ perceptual organization or belief system is an important factor in counsellor effectiveness. The implications for counsellor selection and training are discussed, and suggestions are made for further research on this topic.     

Constructing and deconstructing psychotherapeutic discourse

This paper reviews recent work on the social construction of the self in counselling and psychotherapy, and argues that we need to attend to the ways in which the therapeutic self is fashioned (a) in relation to the ‘psy-complex' as the network of theories and practices concerned with psychological governance and self-reflection in modern Western culture and (b) in the context of ‘therapeutic domains' outside the clinic and academe, domains of discursive regulation and self-expression which then bear upon the activities of professional and lay counsellors. Therapeutic domains contain repertoires, templates and complexes within which counsellors and clients fabricate varieties of truth and story a core of experience into being. I then turn to describe and assess some of the various ways in which this kind of critical reflection on therapeutic discourse and counselling practice now already underpins the work of social constructionist ‘narrative' therapists. Some attention is given to the different pragmatic and deconstructionist approaches which make the discursive constitution of the problem into the problem, either by dissolving or by externalizing the account the client presents. Here I argue that the activities of social constructionist counsellors can be viewed as forms of deconstruction-in-process (a deconstruction of the discursive frames which have been constructed by the client), but that they should not be viewed as stepping outside the discursive conditions of possibility which ground their work. the psy-complex and therapeutic domains still function as relatively enduring structures which limit the degree to which we may construct and deconstruct psychotherapeutic discourse.     

Counsellors’ and psychologists’ experience of working with male survivors of sexual trauma: a pilot study

A qualitative study was undertaken to enhance awareness of the therapeutic needs of the male survivor of sexual trauma through exploration of counsellors’ and psychologists’ experience of working with this client group. The participants were 32 counsellors and psychologists who work for an NHS Trust department. Interpretative Phenomenological Analysis was used to analyse the data which was gathered by means of a postal questionnaire. Six categories emerged from the analysis that highlighted prevalent experience. These were: (a) that the therapist's gender was important, (b) professional concerns, (c) the importance of the relationship, (d) transference/counter transference, (e) that male and female abusive experiences are the same and (f) attention to client's presenting problems. The main conclusions derived from these results and implications for practice are considered.     

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.     

The ‘tyranny of time’: getting to the heart of the impact of educational cuts on the provision of guidance counselling in Ireland

The Irish Education Act (Government of Ireland 1998) stipulates that each young person in secondary school in Ireland is entitled to access ‘appropriate’ guidance. It has been argued that this very right has been eroded since Budget 2012, where resource re-allocations in guidance counselling are obstructing the requirement for schools to implement this section of the Act. This qualitative study explored the effects of ‘educational cutbacks’ from the perspective of guidance counsellors. Findings from interviews with guidance counsellors, suggest that the effects of such cutbacks in guidance counselling are far-reaching and ultimately students are the one’s losing out. The paper proposes that there is a need to reinstate guidance counselling hours to allow guidance counsellors provide a comprehensive service to young people – which they are entitled to.     

Innovation in health care teams

While there has been much research on organizational innovation and on individual creativity, little research has examined the social psychological factors predicting work group innovation. In this exploratory study, using a new measure of innovativeness, eight health care teams were studied. Members of five ‘innovative’ and three ‘traditional’ teams (comprising 43 health care professionals) completed questionnaires examining aspects of individual and group work experience, and produced inventories of innovation reports. On the basis of these inventories, team innovativeness was rated by experienced health care professionals. Team innovation was predicted by climate for innovation (in particular tolerance of diversity), team commitment and team collaboration. The content of health care team innovations was also examined to reveal current trends.     

Towards a new way of healing: experienced counsellors’ perceived influences of ch’i-related experiences on counselling practice in Taiwan

This narrative study explored how the experienced counsellors utilised the idea and practice of ch’i during counselling sessions. The data were co-constructed between the researcher and 12 senior counsellors with substantial ch’i-related experiences using a semi-structured in-depth interview method and were analysed employing a narrative analysis approach. The core themes emerging from the study were (a) an embodiment, which included two sub-themes: ch’i as a way of expressing health and illness and ch’i-related exercise lived out as an embodiment, and (b) ch’i as a way of understanding. The findings pointed to ‘a new way of healing’, which involves perceiving, containing and conveying ch’i and requires counsellors to empty themselves, and remain in a state of non-action and wholeness.