Counselling and the schizophrenias

Schizophrenia is the collective name given to allied psychiatric disorders each of which has received a number of different professional interpretations. A primary counselling task is to help staff resolve conflicts over treatment, and give them support during their care of patients. Counselling patients and families, particularly through opportunities provided by self-help groups, is also discussed. The specialised work of genetic, psychoanalytical and behavioural counselling is considered, and stress is laid on the importance of counselling the adolescent schizophrenic for whom early help is vital to prevent deterioration. The article focuses on those areas where marriage guidance counsellors, social workers and probation officers are most likely to be consulted.     

Counselling on Death and Dying

The growing concern for improved quality of care for the dying and the bereaved is reviewed. The growth of the hospice movement, home-care teams and self-help groups are referred to, together with the attempts that have been made to evaluate the effectiveness of bereavement counselling. In the light of current work and formal psychological studies, an outline of the grief process is given. Reference is made to possible future developments in this field and to the importance of counselling skills being acquired by a wider range of people than at present.     

Buddhism and Counselling

The relevance of the principles and practices of Buddhism to the field of counselling is discussed. Buddhist techniques have already been used by the helping professions in many settings (e.g. Japan, Sri Lanka). The extension of their use to a wider range of settings, and to a wider group of clients, is both feasible and desirable. In addition to the obvious relevance of Buddhist techniques to clients who have a Buddhist background, it is argued that they have a wider applicability. As Buddhism espouses the notion of a productive and healthy lay life, it offers ways not only of dealing with problems and difficulties, but also of improving psychological well-being in general. Examples are cited of relevant Buddhist techniques and their application. It is argued that, once systematically evaluated, many of these could profitably be incorporated into the repertoire of techniques used in present-day counselling and therapy.     

Counselling the dead!

The paper discusses the author's meeting and a counselling encounter in Varanasi (formerly known as Banaras) with a former High Court Judge, who has renounced the material world, excised all his attachments, abandoned his wife, his children, his grandchildren and a luxurious and prestigious life-style, and taken on the mantle of a sanyasi in search of enlightenment and nirvana. He has left his hometown and for the past two to three years has been living on the banks of the river Ganges in Varanasi, the holiest of holy cities in India, leading the life of a mendicant, living off the charity of the hordes of pilgrims who come to Varanasi all around the year.     

Pastoral Counselling

The beginnings of the modern pastoral-care and counselling movement in the 1960s are reviewed, in particular, the attempt to integrate theology with the behavioural sciences, and the theories born of that integration with the practice of pastors and religious leaders. The developments of the last ten years are explored and the tensions of the movement analysed. Pastoral counsellors' contribution to counselling in general in the United Kingdom, and to pastoral ministry both here and overseas, is assessed.     

Counselling and Pain Relief

Health-care staff (e.g. doctors, nurses, physiotherapists, occupational therapists) frequently have to care for patients who suffer from conditions which cause crippling pain. Pain relief is part of such treatment. This article suggests how counselling, as a skill which every health care worker could acquire and use, may reduce the level of pain by helping the sufferer cope more effectively with it. Four principles of pain relief are considered: the therapeutic relationship; other sensory input; rest and relaxation; and the use of imagery. The discussion on pain relief centres on rest and relaxation and the use of imagery, based mainly on the work of Jung and Assagioli's model of psychosynthesis. Patients are encouraged to continue practising these pain-relieving techniques when counselling has ended. By so doing, they will acquire positive ways to escape from the world of nightmare in which sufferers from chronic pain are often held prisoners. An account is included of how a sufferer from trigeminal neuralgia benefited from one session in which imagery was used.     

Counselling and primary prevention

Counsellors/therapists have much to contribute to preventionists concerning the social causes of individual distress. Such insights will lead to efforts to change society to reduce the environmental stresses, including racism, sexism, ageism and homophobia that lead to emotional problems in members of groups at risk. Political efforts by conservatives stress the medical model argument that all mental disorders are diseases or dejects of the brain and/or genes, thereby making social changes unnecessary. An alliance between counsellors and preventionists is necessary to oppose this personal defect position. The struggle for a more just and equalitarian society goes on. We must work together in this struggle.     

Counselling and academic achievement

The possible relationship between emotional difficulty and under-achievement and wastage is examined. Psychometric data is presented from a recent longitudinal study on university students which suggests that psychological and academic difficulty may be different presentations of similar core problems. Particular attention is paid to the interaction between the individual and the institution, and clinical illustrations are provided. It is concluded that psychotherapy and counselling may be the appropriate response to a proportion of students in academic difficulty.     

Counselling and Sex Therapy

Qualified counsellors do not necessarily feel competent to work with their clients' sexual issues. It is argued that the principles underlying good sex are the same as those which underlie good counselling practice. It is also suggested that sex therapy in the form of a behavioural exercise programme - whilst valuable in many cases - is not necessarily the only way of working with sexual issues, and that other therapeutic approaches merit attention.     

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.     

Family Relationships and Counselling

During the last ten years, family therapy has developed a number of distinctive schools of work. Four such schools—structural, strategic, the Milan school, and psychoanalysis - are described, and their importance to British workers is examined. Comments are offered on a variety of issues likely to face those engaged in family therapy in the coming decade.     

Youth Counselling

Youth counselling and advisory work takes various forms in various settings. Against a background of key trends affecting the lives of young people, the range of such services is outlined. Particular attention is paid to generalist youth counselling and advisory agencies, to guidance and support in the Youth Training Scheme, and to relevant work in the Youth Service. The importance of promoting autonomy, and at the same time responding to wider social and political influences on individuals and services, is emphasised.     

Counselling studies

It is proposed that a discipline of 'counselling studies' be considered as an extension of counselling and a contribution to social guidance. Likely features of such a discipline are suggested, including a focus on the individual person, interdisciplinarity, humanistic values, applied and theoretical dialectic, critical attitude and dynamic nature. Questions of suitable name, location and goals are considered. Some indication of possible contents is given in the article.     

Counselling the Unemployed - Help and Helplessness

The role of the counsellor is discussed with special reference to the reactions to job loss amongst a group of 100 white-collar unemployed. The importance of fitting counselling style to the phase of unemployment, and individual differences, is emphasised. Emotional and practical support by the counsellor is important, but it can be considerably enhanced by harnessing family and community resources. Ultimately, unemployment needs to be seen in its social context, and not just as an individual's own problem.     

Counselling and the social construction of self

The specific and Comparatively narrow nature of selfhood which counselling suggests is examined. It is argued that the discourse of counselling is directly and powerfully related to the social construction of self. The social consequences of two central notions of this constructed self—authenticity and autonomy—are debated. It is proposed that, far from being necessarily socially desirable, the propagation of these notions within selfhood may have some derogative consequences to social relations, within communities and within society. It is suggested that counsellors need to develop much more awareness of the sociological perspective of their profession before enthusiastically propagating the authentic, autonomous self.     

Counselling in the enterprise culture

The way in which therapeutic models and language have been dravm upon to provide support for concepts of human flexibility and 'human resource development' in the enterprise culture ofthe 1980s and 1990s is described. The use ofhumane managerial rhetoric to mask the practice of increasingly ruthless public and private-sector organisations, and the dilemmas posedfor counsellors operating within these kinds of institutional settings, are examined.