Counselling after Stroke: An Unmet Need?

Information was gathered by means of a questionnaire survey and interviews from a group of patients (N = 17) and health professionals (N=13) working within a stroke unit, concerning the emotional needs of patients and and their relatives and how staff responded to these needs. Although most of the staff had received some training or information about counselling and felt that their interactions with patients often involved an element of counselling, there was strong support for separate specialised counselling services to deal with psychological problems suffered by both patients and their relatives. Patients rated assistance with personal and emotional worries and advice about physical problems as equally useful. A strong need for a counselling service in some form or other was expressed by patients. Neither the level of the patients' social support nor the presence or absence of aphasia, however, predicted the strength of interest expressed. It is concluded that specialised psychological help could be useful in various ways for both in- and out-patients and for their families.     

Marriage guidance counselling: I. What clients think will help

Thirty-one first-time attenders for marriage guidance counselling were given a non-schedule standardised interview and a client questionnaire. The main aim was to identify the counselling and counsellor characteristics which clients considered would be most helpful in dealing with their problems. Traditional counselling skills such as the ability to be warm, supportive, understanding and a good listener were seen to be important by most clients. However, the vast majority of clients indicated that it would be helpful to receive the counsellor's opinion about their marriage, their personal problems and marriage in general: this is incompatible with a non-directive approach to counselling. Whilst clients may not know best how they should be helped, counsellors who fail to address their preconceptions risk mutual disappointment and premature termination of counselling.     

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.     

Zum Unterstützungsbedarf von Partnern schizophrener Patienten

The aim of this paper is to define concepts regarding the psychological assistance for partners of schizophrenic patients. A total of 28 in-depth interviews were analysed focussing on burdens and needs specific to partners of schizophrenic patients. Additionally, a focal group discussion was carried out. Partners often feel disappointed and dissatisfied with the information and the cooperation provided by psychiatric services. Criticism is directed towards inadequate information and insufficient counselling by physicians, the lack of integration of partners into long-term treatment and neglecting the specific needs of partners by professionals. Partners wish, in contrast, comprehensive information on an individual basis as well as the possibility of an exchange with other partners confronted with similar or identical problems. Generally, psychological assistance and cooperation should be made available as soon as possible after the diagnosis of the disorder. In addition to detailed individual conversations with the treating physician, regular meetings between partners, patient and treatment staff are recommended. Furthermore, specific workshops for partners of schizophrenic patients should be offered, with topics centered on possible changes within the relationship, such as problems with family and household organisation, questions of child education and sexual impairments.     

The effects of classroom teaching on students' self-efficacy for personal development

The personal development of students is an essential component of school guidance and counselling programmes, but no published research on guidance and counselling has investigated the effects of regular classroom teaching on students' self-efficacy for personal development. In this study, questionnaire items were constructed to measure classroom teaching, student self-efficacy for personal development and student use of deep learning strategies. Data were collected from 16,208 secondary school students in Hong Kong. Using structural equation modelling, regular classroom teaching was found to have a direct effect on personal development self-efficacy as well as an indirect effect through student use of deep learning strategies. Implications of these findings for implementing a whole-school approach to guidance and counselling are discussed.     

Career counselling: A process in process

Career counselling, career guidance, and career interventions are terms in the process of evolution. Historical and contemporary factors in the US experience that have changed and expanded the needs for career counselling and related career interventions are discussed. For many work-adjustment problems, in particular, there is a growing acknowledgement that career and personal counselling must fuse. Where this fusion occurs, on a continuum from choice, indecision, and situational concerns to change, indecisiveness, and personal concerns, is analysed.     

Formal and Informal Counselling Help: Students' Experiences

The experiences reported by students who sought help from formal counselling sources were compared with those reported by students who sought assistance from informal helpers. The two groups of students had similar types of problems, but the counselling clients reported (a) higher levels of problem seriousness, (b) lower levels of comfort with the interaction, and (c) higher levels of satisfaction with the help offered.     

Cultural values and attitudes towards guidance and counselling services in one secondary school in Malaysia: the role of a school cultural system

This narrative ethnographic study aims to explore students' attitudes towards guidance and counselling services in one secondary school in Malaysia. Semi-structured individual interviews, group interviews and observations were conducted with school students of different racial backgrounds. They were identified as referred clients, self-referred clients, and those not deemed to be involved in counselling. The data were analysed using the constant comparative analysis grounded theory approach. The findings indicate that there were different attitudes among the three groups of participants concerning counselling services. The study highlights the role of a school system in elucidating attitudes towards guidance and counselling services. It poses implications for understanding counselling services within the school system.     

Interviewee perceptions of an organisational careers guidance scheme

A study was carried out during the early stages of the introduction of a career development scheme in a large government department. Information relating to aspects of various careers counselling issues was gathered from staff who had received such counselling and from personnel staff responsible for its provision. The study shows, amongst other things, that the interviewers were perceived to use some counselling skills, that the interviewers claimed they experienced few problems of role conflict, but that the staff tended to identify the interviewers with management. The findings are discussed relation to the appropriateness of interviewing style and to the broader context of how individuals might influence their career development within the opportunities provided by the organisation.     

Counselling in the workplace: How time‐limited counselling can effect change in well‐being

Background: Many employers provide counselling support on work and personal issues for their employees, but in times of economic pressure such services can be at risk if their effectiveness is not demonstrated. Aim: To evaluate whether time‐limited counselling in a workplace can effect sustained change in well‐being. Method: The study was carried out by a staff counselling team in a university setting. The Warwick‐Edinburgh Mental Well‐being Scale (WEMWBS) was completed by clients at the beginning and end of counselling, and at three and six months following. A non‐treatment comparison group completed the survey at the same intervals. Results: The results of our investigation show clearly that the effect of time‐limited counselling (average seven sessions) on distressed clients is positive. The evidence of our treatment group suggests that they acquire an increased sense of well‐being as a result of the experience of counselling with a significant statistical difference between pre‐and post‐counselling treatment group scores on the WEMWBS and consistently higher scores found post counselling. The improvement was maintained at the same level for at least six months following the end of counselling. Conclusions: The provision of time‐limited counselling by employers is an effective support for personal difficulties affecting work.     

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.     

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.     

Adventure based counselling,individual counselling and object relations: a critical evaluation of a qualitative study

Adventure based counselling is a short-term experiential psychotherapeutic approach, which utilises adventurous activities and being in natural environmental in order to facilitate therapeutic change in clients. The present paper critically appraises the results of a qualitative study that investigated how clients with self-reported anxiety and depression experienced participating in an innovative counselling intervention with combined individual counselling with such an adventurous outdoor transaction. Interpretative Phenomenological Analysis, as described by Smith and Osborn (2008), was used in order record and analyse the experiences of four male and six female students who were treated at the Teesside's University Counselling Service. Interviewees perceived the counselling sessions as offering a safe therapeutic space within which they could unveil their anxieties and achieve inner healing, whereas the outdoor transaction as providing an experiential venue for achieving personal change. Interviewees felt that without the outdoor transaction the therapeutic significance of the counselling process would not have reached its full potential. Likewise, without the individual counselling, the outdoor transaction would just have an entertaining event and not a venue for personal change. These findings are discussed in relation to object relations theory.     

Improving the quality of careers guidance: Towards an understanding of the development of personal models

The process by which careers officers develop personal models of guidance through the interaction of theoretical knowledge with their experiences of training and practice is examined. Semi-structured interviews were conducted with 11 careers officers. Questions were asked about the training and development of careers officers in the practice of careers guidance and counselling with young people. The responses are considered in relation to theories of careers choice, careers counselling and guidance, models of counselling, and the supervisory role in the development of individual practice. Some recommendations are made for improvements to training and supervision for careers guidance.     

The squeezing effect: the cross-cultural experience of international students

The experience of overseas students on study programmes in a higher educational setting in the UK is explored, in an attempt to identify, from the perspective of the individual, how/why the self might be affected during this 'transitional' period. The adjustment required in this period involves accommodating oneself within the frames of reference of the host culture, entailing an apparent tendency to attempt to squeeze one's identity within pre-established conventions. Language restrictions and other affective and situational factors are seen as being detrimental to academic performance, having a knock-on effect on the 'self-concept', and on the overall educational experience, respectively. This issue should be addressed in the context of guidance and counselling, and academic and personal support, for international students.     

Psychological trauma associated with AIDS and HIV infection in women

The growing numbers of women faced with HIV infection and AIDS has specific counselling implications. This paper analyses the psychological needs of all women patients seen by the psychology department (n = 33) over the past 12 months. The mean age was 32.3 years. Psychological crisis was high. Four women reported rapes (three accounting for their HIV infection). Two women had suicide attempts (one on two occasions), Death experiences were notable, including multiple bereavement. Conjidentiality was problematic for many of the women. Problems were reported around pre- and post-test counselling which was absent for three women, and often surrounded the diagnosis of a loved one (child, husband or partner). Most women were first seen as in-patients (when disease progression was extensive) or when their partners or children were in-patients. Despite offers of out-patients follow-up, only four HIV + ve women attended, three of which were irregular. A group of ten women were only seen indirectly when provision of care wasgiven to their children. A consistent group were seen with worries about HIV (either due to sexual contact with a known HZV+ ve or at risk individual) or to unfounded concerns often reflecting underlying psychological problems. This paper explores the counselling challenges of AIDS and HIV for women.     

The effects of behavioral skills training on mand training by staff and unprompted vocal mands by children

We evaluated the effects of a training package, including instructions, modeling, rehearsal, and feedback, for training staff members to conduct mand training with children. Experimenters collected data on staff performance on each step of a task analysis of mand training and on unprompted child vocal mands. Training resulted in increases in staff performance in mand training and in unprompted mands by children. We observed replication of these effects across settings for all staff and for 3 of the children.     

The influence of Confucianism: a narrative study of Hong Kong teachers’ understanding and practices of school guidance and counselling

School guidance seeks to promote the whole person growth of students. It is regarded as an integral part of an educational programme. In Hong Kong secondary schools, a team of teachers are responsible for school guidance. This article examines how guidance teachers made sense of their caring work in general and specifically the counselling services they offered to students. With the use of a narrative analysis and personal experience methods, the study explores the experience of guidance teachers in counselling. Twelve in-service teachers who had enrolled in the Postgraduate Diploma in Education programme at the Hong Kong Institute of Education were interviewed. The influence of the Chinese philosophy of Confucianism, emerging as a theme from the data, was prominent, as its key principles were incorporated into the teachers’ personal systems of counselling. The findings illuminate the influence of Chinese culture in Hong Kong schools. Implications for the promotion of culturally responsive approaches to counselling and culturally competent practices for helping are discussed.     

A humanistic developmental model of counselling: A psycho-educational approach

A developmental model of counselling, based on humanistic principals of psychological functioning, is proposed. A psycho-educational approach, in which counsellors are seen as helping clients develop skills rather than solve problems, is discussed. The counselling model involves three stages: exploration, intervention and empowering. The intervention stage includes techniques focused on affect, behaviour or cognition, as suggested by the ABC model of personal change described in the paper.     

Counselling Requirements in a Voluntary Advice Agency

Voluntary advice agencies are frequently used by people during times of their lives when they are under emotional pressure: for example, following marital disruption, bereavement or redundancy. In order to assess the nature of personal problems and the psychological effects of such life-events, one such advice agency was observed. From a detailed analysis of a sample of client contacts, it was concluded that there was a well-defined need for counselling to be available in addition to the provision of practical and legal information. Using an action-research strategy, the training of existing volunteer staff was extended, and recommendations were outlined for the recruitment of counsel ling-trained staff.