Are You Being Served? The Relationship between School Climate for Service and Teachers' Engagement,Satisfaction, and Intention to Leave: A Moderated Mediation Model

The notion of service has been receiving increasing attention in organizational psychology literature in recent years, due to the client-oriented managerial movement. Yet, little to no attention has been paid to the service notion in educational psychology despite its high relevance to educational settings, given the pressure to be more service-oriented and possess a client-focused state of mind. The present study explores the notion of service in school domains by examining the joint effects of climate for service and the internal service in schools on teachers' work attitudes: work engagement, job satisfaction, and intention to leave their work. The notion of climate for service emphasizes the school's attitude of teachers as service providers to its clients (students and their parents); internal climate emphasizes the school's attitude of providing service to its teaching staff. The study was conducted via a sample of 423 teachers from 30 different schools in Israel. We hypothesized that the indirect relationship between the climate for service and teachers' job satisfaction and intention to leave work would be mediated by teacher work engagement. Our findings supported this hypothesis. Moreover, this indirect relationship via teacher work engagement was demonstrated most strongly when the internal service quality received was high, providing teachers with the capability to deliver what the service climate motivates them to do. Therefore, service-oriented resources—both climate for service and internal service—may be crucial in affecting teachers work attitudes and should be specifically targeted by principals and other educational decision makers.     

Employment and Roles of Counselors in Mental Health Agencies

The authors studied the employment of counselors with master's degrees in multiservice mental health agencies. The study focused on the types of clients seen, the direct care services provided, and the administrative duties performed. Results suggested that the employment of counselors does not differ significantly from the employment of individuals with master's degrees in psychology and social work. Also, the data indicated that counselors are delivering direct care services that traditionally have been offered in mental health centers, that clients seen by counselors demonstrate a range of mental disorders, and that counselors are responsible for fulfilling various administrative duties.     

Counselling in higher education: the experience of lone counsellors

A qualitative study was conducted into the experience of student counsellors working as lone counsellors or as members of a small team in higher education colleges. The data, gathered through semi-structured interviews of eight participants, all of whom were responsible for the management of their counselling service, revealed the complexity of the student counsellor's role. While the one to one work with clients was seen as the primary task, the significance of the counsellor's involvement in the organisation was not to be underestimated. Issues around case load, support and relationships with colleagues, which can be problematic for counsellors working in organisations generally, were highlighted for those working as lone counsellors.     

Theory and Practice: Ernest Becker: a vital resource for counselling psychology

In this article we highlight the work of Ernest Becker for counselling psychology professionals and provide a brief overview of Becker's contributions. Several important themes from his writings relevant to counselling psychology are reviewed, including: the uniqueness of man, socialization and self-esteem, culture and heroism, the relativity of heroism, the fear of death, and the dynamics of evil. We also discuss some of the implications of Becker's work for counselling psychology and counselling psychology professionals, including: providing an integrative perspective on human behaviour and development, implications for multicultural counselling, understanding the hero system, the centrality of death in life, and helping people make meaning. We consider Ernest Becker's work a vital resource for counselling psychology.     

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.     

Outcomes in clients transitioning from in-person counselling to telehealth counselling with trainees

The onset of the 2020 COVID-19 pandemic necessitated a rapid transition of mental health services from in-person to telehealth counselling. Despite the far-reaching impact of this transition, we know little about the impact of this transition on outcomes for clients working with counsellor trainees. The present study utilised longitudinal data collected from a counselling training centre at a major U.S. university to compare client ratings of depression, anxiety and working alliance across 1) in-person services delivered (i.e. pre-pandemic) and 2) telehealth services delivered after the pandemic began (i.e. intra-pandemic) among the same group of clients. Results support our hypothesis that changes in clients' self-reports would be generally equivalent across in-person and telehealth services. Depression and anxiety symptoms decreased, and working alliance tended to increase during both in-person and telehealth care; however, these trends were only statistically significant during telehealth services. Limitations related to sample size (N = 15 clients; up to 17 sessions per client) and low statistical power are discussed. Nonetheless, this study supports the growing body of literature supporting the efficacy of telehealth counselling services. We provide suggestions for future telehealth research and discuss implications for counsellor training.     

Counselling psychology in South Africa

The origin and development of counselling psychology in South Africa has been profoundly influenced by the country’s sociopolitical history and the impact of apartheid. As a result of this, counselling psychologists in the country face a number of challenges and opportunities for the future. In this paper we provide a portrait of counselling psychology in South Africa by describing the current character of the specialty and the context in which South African psychologists work. We critically discuss the challenges that the specialty faces to meet the country’s mental health care needs, contest the current Scope of Practice; affirm multiculturalism without essentialising or reifying race and ethnicity, and build an evidence base for community interventions in the country. We also consider how, in the future, counselling psychologists in South Africa may make a more meaningful contribution within public health and the country’s health care and education systems.     

A personal view: Counselling and women

This personal view explores a number of gender issues relating to counselling and women clients. Attention is drawn to the lack of content of many training courses in the psychology, sociology and biology of women. Links are drawn between a woman's position in society and mental health. It is argued that counsellors need to be alert and sensitive to women's special needs and to avoid an emphasis on intra-psychic aspects at the expense of acknowledgment of societal pressures.     

An initial study of transgender people's experiences of seeking and receiving counselling or psychotherapy in the UK

Background: There are no published empirical research studies exploring transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. As a result, counsellors know little about why transgender people seek counselling, who they seek counselling from, and what their experiences are of receiving counselling. Aim: To address this gap in the literature, this study investigated transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. Funding for this study was provided by a BACP Seedcorn grant. Method: A mixed method small‐scale qualitative research design was employed, comprising an online survey and five semi‐structured interviews. Findings: Participants tended to seek counselling on two or more occasions and received between 2 and 12 sessions. Participants sought counselling for common psychological concerns as well as gender identity and coming out issues. A fear of being discriminated against and exploring gender for the first time were significant barriers in seeking help. Participants reported mixed experiences of counselling but valued a therapeutic relationship in which they felt affirmed, listened to and understood. Discussion: The findings from this study mirror aspects of previous research conducted in the USA concerning transgender clients' experiences of counselling. However, these findings point to the importance of recognising the potential vulnerability transgender clients experience when seeking counselling and the need for therapists to develop greater awareness, knowledge and competence regarding working with transgender clients.     

Dual realities – The search for meaning: Psychodynamic therapy with physically ill people

Abstract

We summarize Kohut's (1971) bi-polar self which enables counsellors to understand and treat narcissistic behaviours and narcissistic personality disorders in a psychoanalytic framework. After Patton and Meara (1992), we describe Kohut's formulations regarding self-development and disorders of self and how such formulations inform critical components of psychoanalytic counselling with particular emphasis on the explicit and implicit strategies and characteristics the counsellor brings to the process. Finally, we suggest that a promising arena for future theorizing and applications of Kohut's ideas is consultation with parents, teachers and other community leaders to help prevent or remedy psychological self-injuries with systemic interventions outside short-term counselling or long-term therapy.

We have suggested that Kohut's self psychology is a good vehicle for understanding what brings a client to counselling: namely, disorders of the self or self-injury. We review strategies and ‘ways of being’ a counsellor must bring to and offer in the counselling encounter if the work is to succeed. We also examine implicit qualities (beyond the achievement of a mature bipolar self) we believe a counsellor or any facilitator must have if counselling or other helping relationships are to be effective. We purpose further conversations and empirical analyses which specifically and conceptually link critical components of psychoanalytic counselling to self psychology and to essential counsellor traits or virtues that seem intrinsic to good counselling practice.     

Exploration of counsellors' perceptions of the redesigned service pathways: a qualitative study of a UK university student counselling service

To address the mental health needs of students, UK universities offer bespoke student counselling services. Economic pressures have led services to find innovative ways of redesigning their service pathway. Few studies have investigated staff perceptions of these changes. The aim of this study was to investigate perceptions of staff employed as counsellors at a student counselling service at a UK university that underwent service delivery changes. Face-to-face interviews were conducted with counsellors (n = 5). Framework analysis was used to identify themes and meta-themes. Five meta-themes were identified: the overarching service ethos and service working style; change in the university context; impact of change on working practice; recording and perceived impact on confidentiality; acceptability and effectiveness. Changes to the service resulted in a more efficient service that is perceived to be more acceptable to students. Staff perceptions differed regarding how changes have affected their counselling practice. Despite these differences, the increase in workload was consistently expressed. Tensions remain as staff strive to maintain high standards of service in this changing context. Future research should investigate the process of developing and implementing change as student counselling services strive to evolve sustainable ways of working.     

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.     

Qualities of reflection: using Saul’s (2001) On Equilibrium to restore humanity to reflection in healthcare

Reflection features strongly in health and care work as a tool for personal and professional development and can support us as practitioners to be critical and self-aware in practice, of practice and the impact on clients and patients. Its power to transform learning and practice, however, has been watered down through recipe-following in reflective recording and through the avoidance of recording uncertainty or practice that might not measure against professional codes. Drawing on the humanist philosophy of John Ralston Saul, I suggest using Saul’s ‘six qualities’ as themes for reflective questions. I reflect on the influence of reason through codes of practice and offer suggestions for questions to restore an awareness of Self in work with clients and patients. Finally, from my experience as a counselling student and healthcare educator, I argue that we should have a greater appreciation of the power of uncertainty in reflective recording.     

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.     

The effectiveness of UK student counselling services: an analysis using the CORE System

Despite concern surrounding the mental health of students, brought about by the government's policy of widening participation and increasing demands upon students, the effectiveness of student counselling has been a neglected research area. This study examines data from seven UK student counselling services using the CORE System in the routine evaluation of their services. Results indicate that counselling is effective, with 70% (service range 67% to 83%) of clients with outcome measures available showing reliable improvement on the CORE-OM from pre- to post-therapy. However, students who complete a course of counselling show significantly greater improvement, according to practitioner pre- and post-therapy severity ratings of depression and anxiety, than those clients who drop out or have an unplanned therapy ending (effect size 1.03, 0.85, respectively). The stage at which students drop out of therapy is important, with those students dropping out of therapy before the third session being the most vulnerable. The implications of these findings are discussed.     

A naturalistic study of the effectiveness of time-limited counselling with low-income clients

The role of counselling and psychotherapy services in relation to the needs of economically disadvantaged individuals has been largely neglected in the recent research literature. Although a small number of theoretical papers and case analyses have been published, there is an absence of studies that examine the effectiveness of counselling with this client group. The present paper reports on a naturalistic outcome study of the effectiveness of time-limited counselling (seven sessions) with low-income clients. Analysis of pre-counselling, postcounselling and follow-up measures of mental health and problem ratings indicated levels of change equivalent to those achieved in controlled studies of counselling and psychotherapy with other client groups. Factors influencing the effectiveness of counselling included gender and employment status. Qualitative client reports suggested that the main benefits experienced by clients were in the areas of self-understanding and self-belief. For illustrative purposes, data from low-income clients are compared with results from employee counselling clients receiving a similar service. The implications of these findings for further research are discussed.     

How counselling psychologists are perceived by NHS clinical psychologists

The aim of the study was to obtain data reJlecting NHS clinical psychologists' perceptions of counselling psychologists. A 19-item questionnaire was devised and sent by post to 303 clinical psychology departments throughout the United Kingdom in July 1995. 161 replies were received from areas including mental health, community care, general hospital, neurological rehabilitation, learning disabilities and combinations of these. Results showed considerable confusion among clinical psychologists around the identity and competencies of counselling psychologists. Much of this confusion seems to be attributable to a lack of information regarding the content of training and a lack of awareness that counselling psychologists are now chartered under the auspices of the British Psychological Society. The survey suggests that counselling psychologists should work to clarify their identity and increase communication with professional colleagues before their contribution to the provision of psychological care can be recognised.     

Multicultural Training Experiences as Predictors of Psychology Students' Cultural Competence

The psychologists in the western world, including Australia, are required to be culturally competent because of the cultural diversity of these societies. Previous studies conducted in North America and Europe have found multicultural teaching, clinical experience with culturally diverse clients, and discussion of multicultural counselling issues in supervision to be related to the practitioner's cultural competency. The present study examined factors contributing to trainee psychologists' perceived level of cultural competence. It was hypothesised that multicultural teaching, clinical experience, and supervision would be related to students' level of cultural competence. One hundred twenty‐seven postgraduate clinical psychology students completed an online survey battery that included demographic information, a social desirability measure, and the Multicultural Mental Health Awareness Scale. This hypothesis was partially supported. Clinical experience and supervision focusing on multicultural issues were found to be related to participants' perceived cultural competence; however, multicultural teaching was not. These results provide insight into how universities around Australia can facilitate future psychologists' competence in working with clients from different cultural backgrounds.     

Financial and practical implications of counselling psychology training: A student survey

It is common knowledge that students make considerable sacrifices in order to pursue a course of study, and there is no reason to belive that counselling psychology trainees are any differnt in this regrd. The results are presented of a survey of 56 postgraduate students in the greater London area which addressed some of the practical and financial implications of counselling psychology training. While none of the respondents was registered on a BPS recognised course, the majority intended to become Chartered Counselling Psychologists. Many t rainees had considerable debts as a consequence of having to pay tution fees, for personal psychological counselling and in some cases to for the supervision of their practical work with clients. Most trainees found that they had to set up their own practice placements, which were unpaid, and had difficulty doing so. The majority of respondents devoted, on average, 30 hours per week to their studies while nearly 60% had a paid job (not related to counselling) to help them cover their expenses. Inplications are discussed for conunselling psychology training in the 1990's and beyond.     

When Words are not Enough: Psychotherapy with Clients Who are Living Below the Poverty Level

The present article describes six strategies found useful when working with depressed clients who are struggling with severe financial limitations. First, it is important to help clients maintain an attitude of hope for a better future, so they remain as positive yet realistic about their current options and future goals. Second, empathy is considered to be a central component in all psychotherapy sessions, helping therapists to understand their clients’ life experiences and ongoing struggles. Third, clients can learn to develop more adaptive perspectives about life, family, and friends, trying to focus on the positive events they have experienced and the supportive bonds they have developed. Fourth, clients can develop new specific coping skills that may help them to manage the problems they encounter. Fifth, many clients can better utilize the social support that is often available, starting to ask family members and friends for assistance and support when help is needed. Sixth, an interdisciplinary treatment team is often optimal when the treatment plan integrates the potential benefits derived from psychotherapy, medications, and social service agencies. An effective psychotherapist respects the limits of psychology while consulting with colleagues from other health care professions. These six strategies can help guide therapists when working with clients who are struggling with persistent depression in the face of adversity.