Psychoanalytic psychotherapy and student counselling

This paper explores the experience of a psychotherapist working in a university counselling service, indicating the contribution I think a psychoanalytic orientation can make to this kind of work. The exposed ‘coal face’ nature of the work is illustrated, and some of the psychotherapeutic implications of working within a large organisation discussed. There is an exploration of institutional dynamics which bear directly upon the psychotherapist, in terms of what it is possible to provide, and of professional self-preservation and self-esteem. Analysis of the uses made of the counselling service is seen as a contribution towards enabling the service to represent properly itself and its concerns within the institution.     

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.     

Bulimia

No abstract available for this article.     

A survey of student counselling in higher and further education in the United Kingdom

All higher and further education institutions who reported having a student counselling service were surveyed, using a postal questionnaire, during 1985. Information from 212 institutions is presented. It describes what services exist, how long they have existed, their staffing and their workload (in terms of numbers counselled and type of service offered). Comparisons between universities, polytechnics and colleges of higher and further education are made. The stated objectives of the counselling services are summarised, together with identified priorities in counselling functions. Some of the characteristics of counsellors are outlined, including hours worked, training and qualifications.     

Self-evaluation and self-perception of student learning in person-centred counselling training within a higher education setting

This is an account of some of the learning experiences of mature students undertaking a Level 2 Diploma course in Person-Centred Counselling over four terms in a higher education establishment in England. The central question driving this research stemmed from a desire to understand the student experience of becoming professional. Therefore the question was that of qualitative inquiry: ‘What are the experiences of mature learners on person-centred counselling courses within higher education?’ This paper discusses students’ perceptions of training and the ways in which they evaluate their status as professionals.     

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.     

Bulimia nervosa and dietary restraint

Patients with bulimia nervosa were compared with non-bulimic restrained and unrestrained eaters on several questionnaire and interview measures related to eating patterns, preoccupation with dieting and food, and general psychopathology. Bulimic subjects did not differ significantly from non-bulimic restrained eaters on measures of fear of weight gain, dietary restraint, and the Eating Disorders Inventory (EDI) subscales of Drive for Thinness and Body Dissatisfaction, although both groups scored significantly higher on these measures than unrestrained eaters. Subjects with bulimia nervosa differed significantly from both restrained and unrestrained eaters on the Eating Habits Checklist, the Beck Depression Inventory, the EDI total score and Interoceptive Awareness, Introversion and Bulimia subscales, the Three Factor Eating Questionnaire (TFEQ), Disinhibition subscale and the Symptom Checklist 90-revised version. These findings show that bulimic patients may be quite similar to their restrained, non-bulimic counterparts on dietary concern and ideals of slenderness and suggest the importance of including a restrained control group in attempts to isolate the variables that differentiate individuals with the clinical eating disorder from their peers who demonstrate normative discontent about body weight and shape.     

Some ethical dilemmas in counselling and counselling research

This paper raises a number of dilemmas in relation to the ethical practice of counselling, counsellor training and research and evaluation of counselling which reflect the author's increasing concerns about therapeutic ethics. A number of relevant issues are explored to develop awareness and understanding of ethical matters, though this is in the spirit of exploration and inquiry rather than having definitive answers to offer. These issues include: use of training videos of therapists with real clients; informed consent; how research and evaluation changes the therapeutic process; how sensitive and ongoing consent for counselling and counselling research could be best obtained; publication of research in ways that respect the research participant; and the value and implications of the new British Association for Counselling and Psychotherapy ethical framework. Finally, the concept of 'ethical mindfulness' is considered as a creative, if demanding, response to a concern to be ethical in research and practice.     

Bulimia: psychoanalytic perspectives

Bulimia, the syndrome of food binging often followed by purging has been reported to be increasing in recent years. This communication reviews the psychoanalytic understanding of eating disorders, focusing on the pathology of early object relations and later intrapsychic conflicts over incestuous impregnation fantasies. Ancillary symptoms of kleptomania, laxative abuse, and vegetarianism are discussed, and associations with masturbatory conflicts and early adolescent phallic activity, i.e., horseback riding, are elaborated.     

Bulimia and taste: possible interactions

Potential abnormalities of taste were examined in bulimic subjects who purged by vomiting and in controls. When spatial testing of the tongue and palate was performed by direct local application of sweet, salty, sour, and bitter solutions, bulimics showed a selective spatial loss on the palate. The palate may be affected by purging because vomit is directed toward the roof of the mouth where the palate receptors are located. The data suggest that the acid in vomit damages these receptors. Bulimics and controls did not differ in their basal ratings of intensity or pleasantness of sweet, salty, sour, and bitter stimuli when these were sipped rather than directly applied to the tongue. However, after ingesting a glucose load, controls found sweet taste significantly less pleasant, whereas bulimics did not. The results suggest that bulimics may also have an abnormal experience of satiety.     

Replacing client-centred counselling with culture-centred counselling

Models of psychotherapies and counselling do not develop in a social vacuum. They arise out of and rest on several fundamental assumptions-social, linguistic and cultural-most which are understood and shared by the client group and the therapists andor counsellors. The extent to which there is a congruence of shared assumptions facilitates the process of counselling and/or therapy. It does not, however, guarantee its successful outcome. This paper examines the fundamental assumptions underlying client-centred counselling and argues that there is at present a lack of correspondence between the assumptions of the counsellors and those of their client groups-even within their own culture. But among the client groups comprising the ethnic minorities originating from the Indian subcontinent, there is a wide chasm. The clients do not understand or share the fundamental assumptions of their counsellors. As a result, client-centred counselling is irrelevant and does not serve the needs of the clients groups comprising the ethnic minorities. It is in urgent need of a paradigm shaft. It is argued that client-centred therapy needs to be replaced by culture-centred counselling, in which counsellors can be trained. The paper presents the main features of a model of counselling that is applicable not only to the white indigenous population in Britain but to the above ethnic minorities living in Britain.     

Simulation and counselling

Simulations are basically models of social and physical situations. Their educational value and the problems involved in using simulation techniques are analysed, and some possible applications of these techniques in counselling are outlined: these include applications in counsellor training, in one-to-one and three-person counselling situations, and in preparing pupils for such experiences as job interviews. But dangers of “faddishness” have to be avoided, and more rigorous research into the effectiveness of simulation techniques is still needed.     

Anorexia Nervosa,Buliminarexia, and Bulimia

No abstract available for this article.     

Globalising counselling: humanistic counselling in Kenya

This paper explores the application of a Western, psychologically-based model of counselling and counselling training in contexts where the social and cultural conditions differ from mainstream Western societies. A group of Kenyan trainee counsellors following such a course are interviewed about their experience of training. The interview data are analysed to provide a tentative answer to the question of the appropriateness in a Kenyan cultural milieu of a humanistic counselling training model developed in the UK. It is concluded that such application is possible and desirable, if it is undertaken as shared and respectful learning between trainers and trainees.     

Bulimia: Cognitive-Behavioral Treatment and Relapse Prevention

The authors review the assumptions about processes that maintain bulimic behavior. Specific treatment package recommendations are made on the basis of selected outcome literature. Special issues, such as Axis II diagnosis, hospitalization, and psychopharmaceutics, are addressed.