Summary evaluation of the national AIDS counselling training unit in the U.K.

The arrival of AIDS and HIV marked a demand for information and training for a variety of health care workers, many of whom were unskilled in counselling techniques. This study was set up to highlight areas of need and to examine the impact of training on a random sample of 100 participants who were questioned immediately prior to training, post training and at 6 months follow-up. The data suggests that there is a high demand for education, specifically for counselling skills. Workshop participants divide between those who have patient contact and those who do not. Workshops reduced anxiety about contact, procedures and especially counselling. This reduction was maintained at 6 months. AIDS work brings with it some level of stress, but of note was the high level of reward. Rather than address a need, the workshops seemed to create a subsequent demand. Anticipated demand is high, especially in the light of poor facilities reported at participants' place of work.     

The advantages and disadvantages of a brief intervention strategy in a community counseling service

Abstract

The Isis Centre, a long-established NHS open-access counselling facility in Oxford, experienced excessive demand for service. This placed strain on the capacity to deliver, and an unacceptably long waiting list resulted. A brief intervention strategy limited to four counselling sessions was shown to reduce the waiting time. This outcome study tests the hypothesis that the strategy was sufficiently clinically effective to warrant its continuing availability to those who wished to be seen more quickly, rather than waiting for an open-ended contract. Counsellors assessed outcome on clinical parameters and clients were retrospectively asked their views on the acceptability of the method and its usefulness.

There was a high level of correlation between clients' and counsellors' assessment. One-quarter of the study group had an experience classified as ‘useful and sufficient’. However, half felt the experience ‘useful but insufficient’, although this group also thought the intervention provided more than temporary relief. For one quarter, the experience was not helpful, but for some of these it prevented a long, unnecessary time on the waiting list.

While a brief intervention appears to be an effective strategy in delivering a counselling service, further work is necessary to target those most likely to benefit and those for whom a longer-term option should be sought from the start.     

Psycho-social Counselling in Predictive Genetic Testing for Cancer: The Association Between Number of Supportive Sessions and Client Characteristics as Assessed by Psycho-social Workers

Given the increased demand on genetic services, it is important to identify clients who may require relatively more extensive psychosocial support. This paper describes which client characteristics, as assessed in the first psycho-social counselling session, were associated with requiring relatively more psycho-social support (≥3 sessions) in the process of predictive testing for cancer. The study population consisted of 244 counselees for hereditary cancer. Data were derived from an electronic data-base, used by psycho-social workers for the systematic registration of relevant details of each counselling session. Data were analysed for two respective groups: (A) patients who had a known mutation in the family and (B) patients with an as yet unknown mutation in the family. Results show that two or more psychosocial sessions were given if the information derived from the first session indicated the client to have childhood experiences with cancer (in group A), to experience the family role and/or the psychological impact as burdensome (in both groups) or to experience the social impact as burdensome (in group B). We conclude that the first assessment by a psychosocial worker already provides valuable information on the psychological support needs of patients. These findings provide insight into possible problem areas for clients dealing with predictive genetic testing.     

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.     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

Counselling in primary care: a systematic review of the research evidence

Counselling in primary care in the UK is expanding rapidly, and its evidence base needs to be established. We present the rationale for conducting controlled trials of counselling in primary care, and suggest that a systematic review of controlled trials of counselling in primary care is timely. We describe the process of conducting the review in accordance with Cochrane Collaboration guidelines. The review aimed to assess the effectiveness and cost-effectiveness of counselling in primary care, by systematically reviewing cost and outcome data from randomised controlled trials and controlled patient preference trials of counselling interventions, for patients with psychological and psychosocial problems considered suitable for counselling. The search strategy, inclusion and exclusion criteria, data collection and data analysis are described. The results of the review are presented. The review included only controlled trials of counselling in which counsellors accredited by the British Association for Counselling (or equivalent) provided non-directive counselling in primary care. Four trials met the inclusion criteria. Results indicated that patients who receive counselling show a modest but significant improvement in symptom levels compared with those who receive GP care. Levels of satisfaction with counselling are high. There is very tentative evidence to suggest that counselled patients are more likely to be considered recovered than usual GP care patients. There is limited information about the cost-effectiveness of counselling. We conclude by reflecting upon the results of the review and their implications for counselling research.     

Beyond resolution of presenting issues: Clients' experiences of an in‐house police counselling service

The availability of counselling services for employees has expanded significantly in recent years. However, despite an increase in appreciation of the value of counselling within the police service, there has been little research into the effectiveness of counselling with police personnel. The present study assesses an in‐house counselling service provided by the welfare and counselling department of a Scottish police force. Thirteen former clients (including both police officers and civilian support staff) were interviewed about their views on four areas of the counselling provision: how they entered counselling, the issues they brought, their experiences during counselling, and their assessment of the impact of counselling on their lives. Interviews were analysed using a grounded theory approach, which identified four main categories: initial engagement, learning by participating, experiencing moments of deep self‐examination, and moving beyond resolution of presenting problems. All of those who were interviewed appreciated the provision of a counselling service within their employment, and the majority reported that they had not only been helped to resolve their presenting problems, but had also made important gains in self‐awareness and work effectiveness. Findings are discussed in terms of implications for service delivery and future research.     

Gambling counselling in Australia: focus on cognitive counselling techniques

A number of specialised counselling services are now available to assist individuals who experience difficulties as a result of problem gambling behaviour. Clinicians within these services may utilise one or a number of counselling approaches depending on their own preferences and their assessment of the counselling style suitable for use with particular clients. The purpose of this paper is twofold. The first is to describe the range of specialised gambling counselling services now available in Australia. The second aim is to provide clinicians in the field with a range of practical cognitive counselling strategies that may be used to good effect to assist clients to reassess their attitudes towards and thoughts about gambling.     

Brief dynamic counselling: Making the right choice

Abstract

Brief dynamic counselling has become a frequently practised method of treatment. This paper examines the usefulness of short-term therapy for certain clients and describes the relevant selection criteria. However, it is argued that there exists a real danger to the client should they be inappropriately referred for this work. Demands upon therapy services often mean that therapists are under pressure to have a rapid ‘through-put’ of clients. This may lead to some clients being treated in a way that is unsuitable and inadequate for their needs. It is suggested that, more than being inadequate, such a situation could cause additional harm to the client. Professional assessment is considered to be of vital importance. Case material is included in order to illustrate the difference between clients who are likely to benefit from short-term counselling work and those for whom the longer time duration is an essential part of the therapeutic relationship and process. In terms of therapy service provision, the need for flexibility and the need for availability of a variety of treatments are discussed.     

Specialist counsellors in primary care: The experience and preferences of general practitioners

This paper reports the results of a postal questionnaire, pre-coded by practice, which was sent to all 484 Leicestershire general practitioners. Practitioners who could and who could not refer to an in-house counsellor were compared in terms of their views about counselling provision, both within the practice and by agencies outside, such as mental health teams and specialist counselling services. General practitioners having access to a counsellor belonged to practices which were larger and had fundholding status. No signijicant dafference was found between rural and urban practices in their employment of an in-house counsellor, although those doctors working in rural areas were less likely to see this service as having a high priority. General practitioners without in-house counsellors estimated a referral rate (for counselling) in excess of twice that of the actual rate reported by those with practice counsellors. Those having an in-house counsellor were more likely to agree with statements that emphasized the benefits of this form of provision as against that offered by either mental health teams or specialist counselling services.     

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.     

Feedback Seeking Among Developmental Assessment Center Participants

This study examined 189 newly hired supervisors in the transportation industry who completed a developmental assessment center. The results showed that those who performed poorly in the assessment center, particularly on interpersonal dimensions, were less likely to initiate a scheduled feedback telephone call with an assigned coach. Implications and future research ideas are discussed.     

Counselling glue sniffers and solvent abusers

This paper reviews the historical background and the current situation with reference to glue sniffing and volatile substance abuse practices by school children and young people. Various approaches to counselling are described and discussed with a view to encouraging the development of more caring services to treat those chronic cases who are urgently in need of help. It is emphasised that any response to volatile substance abuse should be directed more towards the person than the condition, which may be symptomatic of a whole range of personal problems requiring guidance and counselling.     

SELF- VERSUS OTHERS' RATINGS AS PREDICTORS OF ASSESSMENT CENTER RATINGS: VALIDATION EVIDENCE FOR 360-DEGREE FEEDBACK PROGRAMS

Although 360-degree feedback programs are rapidly increasing in popularity, few studies have examined how well ratings from these programs predict an independent criterion. This study had 2 main aims: First, to examine the validity of ratings from a 360-degree feedback program using assessment center ratings as an independent criterion and to determine which source (i.e., self, supervisor, peers, or subordinates) provided the most valid predictor of the criterion measure of competency. Second, to better understand the relationship between self-observer discrepancies and an independent criterion. The average of supervisor, peer, and subordinate ratings predicted performance on the assessment center, as did the supervisor ratings alone. The self-ratings were negatively and nonlinearly related to performance with some of those who gave themselves the highest ratings having the lowest performance on the assessment center. Supervisor ratings successfully discriminated between overestimators but were not as successful at discriminating underestimators, suggesting that more modest feedback recipients might be underrated by their supervisors. Peers overestimated performance for poor performers. Explanations of the results and the implications for the use of self-ratings in evaluations, the design of feedback reports, and the use of 360-degree feedback programs for involving and empowering staff are discussed.     

The rise in demand for counselling

Explanations for the rise in demand for counselling are discussed. These include dissatisfaction with clinical psychology, the loss of social and personal supports, New Age aspirations for personal development, and insuficient numbers of clinical psychologists. Evidence is presented against the views that there has been a recent loss of social or personal supports, and that personal-development aspirations through unorthodox routes are a new phenomenon. The apparent rise in demand for counselling is explained rather as a rise in demand for counselling training, by would-be practitioners. This demand in turn is fuelled by developments in public-sector employent, leading employees to seek extra qualifications to enhance their job security. Nevertheless, the relatively weak appeal of clinical psychology, together with its low public visibility and its weak licensing power, encourage the continual emergence of alternative therapies.     

Career assessment supervision: Could what we don't know hurt us?

In this brief comment, one marked discrepancy in the career assessment field is identified: many students receive career assessment supervision, and many counselling and counselling psychology programs seemingly place much value on such supemision, but theoretical, empirical, and practical attention has yet to be advanced toward explicating the career assessment supervision process itself Concern over this lack of attention as expressed, and the need to make a more direct, concerted attack on explicating the career assessment supervision process is called for.     

A survey of psychological assessment feedback practices

There have been no previous studies on how often psychologists conduct feedback and whether they view this practice as a useful component of assessment. To explore psychologists' feedback practices and their perception of the effects of feedback on their clients, the authors examined survey data from 719 psychologist members of the International Neuropsychological Society, the National Academy of Neuropsychology, and the Society for Personality Assessment who regularly conducted assessments as part of their professional activities. The results indicated that the majority of respondents (71%) frequently provided in-person assessment feedback to their clients and/or their clients' families. Furthermore, most respondents (72%) indicated that clients found this information to be helpful and positive. Factors contributing to perceived positive feedback effects, including graduate training and feedback session length, were also examined. Last, differences in the feedback practices of psychologists predominantly practicing neuropsychology versus those predominantly practicing personality assessment were sampled and discussed.     

Self‐Supervisor Agreement: The Influence of Feedback Seeking on the Relationship Between Self and Supervisor Ratings of Performance1

Self‐assessment research has continued to search for those factors that increase self‐other rating agreement. The current field study investigated the feedback‐seeking strategies (i. e., monitoring and inquiry) used by 125 employees to obtain performance information, as well as the relationship between feedback‐seeking strategy use and self‐supervisor performance‐rating agreement. Results indicate that the frequency of monitoring reported by employees significantly moderated the relationship between self and supervisor ratings of performance. Individuals who reported higher levels of feedback seeking through monitoring were more likely to have self‐assessments that were congruent with their supervisors' ratings of performance.     

The Enhancing Effect of Overconfidence on Subsequent Learning Performance: Potential Mediation Effects of Dissatisfaction and Effort

Three studies were conducted to investigate whether individuals whose performance on a learning task fell short of their previous overconfident self‐assessment would apply more effort on a subsequent task to resolve their dissatisfaction and thereby achieve better subsequent performance than individuals who made accurate or underconfident self‐assessments. Specifically, Study 1 and Study 2 used overestimation, and Study 3 used overplacement to predict subsequent performance by measuring students' self‐assessments before the first task, their level of dissatisfaction with their actual performance on that task, the effort they applied in learning, and their performance on the subsequent task. Furthermore, Study 3 divided the participants randomly into a false feedback group (the control group) and a real feedback group (the experimental group). The results showed that when controlling for prior performance, participants who were more overconfident tended to express greater dissatisfaction and increase more effort to achieve their desired outcomes when they perceived a gap between their desired performance and their actual performance. Notably, they achieved better subsequent performance, whereas those in the control group who were overconfident neither applied more effort in subsequent learning nor increased their subsequent performance when they received “unbiased feedback.” The implications of these findings for education are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

‘A preparation for practice?’ Students experiences of counselling training within departments of higher education

The literature has identified a gap between the education and practice in the education and training for the practice based professions based within traditional Departments of Higher Education. In the education and training in counselling it is suggested that this gap is primarily between those who view practice as the rigorous application of formal ‘science’ and those who see it as more holistically embedded in ‘tacit knowledge’ and artistry of the practitioner. This paper reports on a small scale qualitative study (Scanlon, 1993) which investigated the experience of students undertaking Counsellor training courses within Departments of Higher Education. Analysis of interview data revealed three main categories of concern. The first categoy describes the adverse effects of the theory-practice gap on the students. The second catego y describes the importance of clinical supervision in acquiring practice skills and the third catego y describes the participants' concerns about the quality of outcome for such training, particularly in relation to the perceived lack of ngour in the assessment of clinical competence. In the light of these findings a number of suggestions about how the professional education and training of counsellors could be better integrated into a more ‘practice led’ curriculum model are discussed.