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.     

Bereavement counselling in Uganda and Northern Ireland: a comparison

Therapeutic interventions for bereavement in Northern Ireland and in the Sub-Saharan African country of Uganda are compared. Semi-structured interviews were conducted with Ugandan (n?=?18) and Northern Irish (n?=?20) therapists. These were thematically analysed. The findings focused on: the counselling context, the characteristics of counsellors, the characteristics of clients and counselling practices. Whilst there were many similarities in practice, core differences arose from the demands of these regions’ predominately collectivist or individualist settings. Findings suggest that counselling interventions require adjustment to reflect cultural practices where there is less emphasis on an individualised ego, and where bereavement responses must concur with social norms.     

Getting curious about meaning-making in counselling (1)1

Counselling offers many experimental opportunities from which counsellors can learn and develop their meaning-making skills. Recent developments in qualitative research, and in social constructionist approaches to counselling, point to new ways of conceptualising the conversations of counselling and guidance. In particular, a hermeneutic view of counselling attunes counsellors and guidance practitioners to the particular meanings and meaning-making potentials clients and students bring to counselling and guidance conversations. Accordingly, our questions and proposed solutions can be seen as engaging the meaning-making efforts of clients in ways we, and they, can learn from. Our conversations offer many potential experiments in meaning-making, should we think of what others do with what we say—as occurring across a gap of conversational potential. This article explores ways to adopt, and learn from, such a hermeneutic frame in our conversations with clients and students.     

Double bind: An essay on counselling training

Gerard Egan's problem management and opportunity development model is currently in use training prospective counsellors, social workers, nurses, managers, etc. the skills of helping. This essay attempts, experimentally, to depict in three different ways Egan's work and its relationship to operations of power: (1) from a relatively uncritical stance, (2) from a personal experience stance, and (3) from a social constructionist perspective. The whole piece, taken together, attempts to tackle the issue of theory as practice — to ground/unmask/make present the ways in which we are socialised into a profession and the problems inherent in that process. Two themes run through the work: the double bind created for a student on a counselling course which makes some claim to train around Rogers' core conditions, and which is also assessed/accredited; the connections between theory, training and practices.     

Resourceful Dialogues: Eliciting and Mobilizing Client Competencies and Resources

Within the social constructionist (narrative, solution-focused and collaborative language systems) therapies, therapists have increasingly focused on identifying and mobilizing clients’ resources and competencies. How such client resources and competencies are identified and elaborated can be considered empirical matters for analysts of therapeutic discourse. The present paper examines resourceful sequences of dialogue in 12 single session lifestyle consultations for how counsellors conversationally engaged consultees, and for what transpired within these sequences of dialogue. These sequences were micro-analyzed using conversation analysis and retrospective comments from consultees and therapists involved in these sequences were solicited using a videotaped replay procedure known as comprehensive process analysis [Elliott (1989). In M. Packer & R. B. Addison (Eds.), Entering the circle: Hermeneutic investigation in psychology (pp. 165–184). Albany, NY: SUNY Press]. The combined conversation analyses and related comments for three of the 23 videotaped passages analyzed are reported with the aim of enhancing therapists’ conversational practices in hosting resourceful dialogues with clients.

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 experiences of person-centred counsellors working with suicidal clients online through the medium of text

ABSTRACT

In this study, we attempt to provide an understanding of the experiences of four UK-based person-centred counsellors working with suicidal clients online using text-based therapies and the impact of their clients’ suicidal ideation upon their “way of being”. The counsellors were selected purposively; each was working as a person-centred counsellor online, was encountering suicidal ideation in their clients, and was a member of a professional organisation. A narrative approach was taken, using unstructured interviews and a stanza format of representation. We found that participants had developed a way of being online that may be distinct from their in-person practice. Challenges included being more directive, lacking physical presence, lacking confidence in assessing risk and questions about empathic understanding. Working online with risk raises specific challenges for person-centred practitioners in line with what is indicated in the little relevant research currently already available.     

A qualitative exploration into how the use of prayer in counselling and psychotherapy might be ethically problematic

Aim: This research article contributes to the debate on the value and limitation of the use of spiritual strategies, like prayer, in counselling (Foskett & Lynch, 2001) by disseminating the insights that were gained from a qualitative study of mainstream counsellors whose work includes prayer. Method: Participants were 19 British Association for Counselling and Psychotherapy (BACP)‐accredited and Churches Ministerial Counselling Service (CMCS)‐approved counsellors who use prayer in their practice. They were interviewed, and the data were analysed using Interpretative Phenomenological Analysis. Results: The data reveal that counsellors who use prayer are aware that ethical problems may be encountered: if prayer changes the way that the counsellor is perceived; when using prayer with issues of psychopathology; if the counsellor uses prayer to impose faith on a client; when being professionally held to account; if prayer is used for avoidance or as a defence; if prayer is used to enhance the counsellor's power; if prayer is not part of the client's agenda; if prayer is used routinely; if prayer cannot be challenged; if there is a cultural pressure to pray; and if the prayer method is not matched to the client – but that their concern over potential ethical issues is not of sufficient strength to override their therapeutic use of prayer if facilitated with due care.     

Client perspectives: The therapeutic challenge of domestic violence counselling – a pilot study

Aims: This qualitative pilot study explored the perceptions of four female domestic violence clients regarding counselling they had concluded in order to identify a preliminary client‐preferred domestic violence counselling approach. Method: Semi‐structured interviews asking about significant events during counselling were held. An adapted grounded theory and narrative methodology was used. Results from the analysis were reviewed with two of the participants. Participants were offered additional counselling support if required after the research interview. Results/Findings: Domestic violence clients found starting counselling particularly difficult after years of keeping the abuse to themselves. Participants actively withheld and managed information for several sessions and needed to know they had time to explore their experiences. The counsellor being consistent and non‐judgemental, and understanding domestic violence and its effects was helpful. Having a clear ending was appreciated by the participants. Discussion: The initial development of the therapeutic relationship benefited from active discussion of how domestic violence could affect behaviour and emotions. Good early therapeutic relationships showed elements of the three main psychological schools. Participants benefited from a pro‐active discussion of endings. A key limitation of this research is the small sample size. Implications for practice: The research suggests that counsellors would benefit from knowledge and skills from different psychological schools and specific training in domestic violence. Allowing flexibility on the number of sessions available to clients may be helpful. Conclusions: Further work is required to explore these preliminary findings. However, early indications suggest that domestic abuse clients may benefit from non‐time‐limited specialist counselling services.     

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.     

Does teaching a solution-focused model of counselling work? A follow-up of graduates

Objective: To explore the ways in which graduates of a university counsellor-education programme reflected on their career development, retained the programme's distinctive theoretical counselling model in their counselling practice and engaged in continuing professional development. The main aim was to discover whether or not teaching a solution-focused model of counselling was worthwhile. Method: A questionnaire, using primarily solution-focused type questions, was distributed to all graduates. Interest was focused on specific events, both inside and outside the training programme and beyond, that contributed to graduates' sense of development as counsellors. Results: Thirty four graduates (response rate 62%) provided responses indicating their recognition that their sense of competence and identification as professional counsellors develops over time, and is assisted by relevant feedback and supervision from lecturers and practical counselling experience. Graduates also indicated that their favoured working model was solution-focused and that, as a framework, it provided them with opportunities to integrate other counselling models and add complementary professional development education. Conclusion: The graduates' continued use of a solution-focused model supports the view that teaching the solution-focused model is working. The findings are considered alongside four models of counsellor development and implications for counsellor-education programmes are explored.     

The challenge of prejudice: counsellors’ talk about challenging clients’ prejudices

This paper considers the implications for training and practice of counsellors’ responses to the notion of challenging clients’ prejudices. It explores tensions in counselling discourse between social responsibility, responsibility to the client and responsibility for one's self as counsellor. Three focus groups of counsellors were asked whether a counsellor should challenge clients’ prejudices. Responses were categorised as challenge, not-challenge or exit responses. Discursive themes identified in the responses are: managing congruence and being non-judgemental; self-care and self-respect; and social responsibility. Strategies for managing the discursive conflicts identified in responding to counsellor-identified client prejudices are summarised.     

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.     

Making use of the vignette technique to examine methods of bereavement counselling: An exploratory study

Aim: The principal objective of this small‐scale study was to examine methods of bereavement counselling because of their lack of clarity. Method: The study made use of the vignette technique along with six semi‐structured interviews analysed by means of thematic analysis. Findings: Results showed that bereavement counsellors are using a multitude of different and diverse methods of counselling, characteristic of postmodernism. Advantages of these postmodern methods are that bereavement counselling methods are rich, creative, supportive, pluralistic and attentive to otherness. However, disadvantages of these postmodern methods have led to a lack of consensus amongst experts, unclear methods and an anti‐methodological way of working by counsellors. Implications for practice: Postmodernism is inherent in bereavement counselling. As a result no two counsellors work in exactly the same way because of the difference in their background and experience similarly it can be said that no one counselling method has exclusivity due to the diverse nature of postmodernism.     

Psychosocial response to COVID‐19 pandemic in India: Helpline counsellors’ experiences and perspectives

The COVID‐19 pandemic presents a threat to physical and psychosocial health of individuals. In lieu of the subsequent lockdown and containment measures, helpline counselling becomes a viable method of accessing psychosocial services during the pandemic. The present paper describes experiences of counsellors working with a special COVID‐19 counselling helpline initiated by iCALL, a national‐level technology‐assisted counselling service of the Tata Institute of Social Sciences, India, which aims to address the psychosocial impact of the pandemic and the lockdown. The paper is based on two focus group interviews held with 11 counsellors during the initial two months of the helpline's functioning. Findings of the study highlight the diverse profile of the callers, with individuals belonging to different strata of society and to marginalised communities. The nature of concerns presented by the callers were often a mix of psychological, relational and practical issues. The resultant distress emanated from an interplay of these factors with the relational contexts, their social locations and social structures the individuals were embedded in. This highlighted the need for conceptualising and responding from a psychosocial lens, whereby interventions involved traditional counselling approaches and strategies for addressing determinants of distress by connecting callers to required ground‐level resources. Counsellors’ engagement with this process impacted their professional and personal selves, necessitating the need for structured and continuous training, supervision and support. At a larger level, the counsellors’ narratives asserted the need for adopting a psychosocial paradigm for conceptualising and addressing mental health concerns in India.     

An inquiry into the emotional impact of sight loss and the counselling experiences and needs of blind and partially sighted people

Background: The link between sight loss and depression is well documented. The UK Vision Strategy seeks to bring the emotional impact of sight loss into public awareness and improve access to emotional support for visually impaired people. However, dedicated counselling services for visually impaired people remain scarce, and research into the effectiveness of psychological interventions is predominantly anecdotal rather than evidence based. Aim: To explore the emotional impact of sight loss in four core areas (mood, self concept, social connectedness and loss), and to explore the counselling experiences and needs of blind and partially sighted adults. Method: Data were collected using the mental health and social functioning sub-scales of the National Eye Institute Visual Functioning Questionnaire-25 and semi-structured interviews transcribed and analysed using grounded theory. Results: Participants with a serious eye condition shared a common transition from sight to blindness, starting with diagnosis, coping with deterioration of sight, experiencing loss in different areas of life, experiencing changed perceptions of self in relation to society, experiencing others in a changed way and experiencing rehabilitation. A theoretical model describing the transition from sight to blindness is proposed. Participants reported negative perceptions of counselling and a lack of counselling opportunities in relation to their sight loss. Implications: The implications for policy and practice are discussed, particularly the need for counselling after diagnosis of visual impairment and the specific challenges facing those who deliver counselling to blind and partially sighted clients.