A qualitative study of client experiences of working with novice counsellors

Aims: This paper reports on a qualitative analysis of written accounts by clients who participated in a counselling relationship with beginning-level trainees. The purpose of the study was to explore how clients experience the process of counselling with novice practitioners. Method: Consensual qualitative research was used for data analysis. Findings: Three general thematic categories were identified – client perceptions of self in counselling; client perceptions of the counsellor; and client perception of the counselling process. Conclusions: Overall, the findings suggest that these clients saw the interpersonal qualities and skills of the counsellor as major contributors to their experience. Implications: Clinical training of novices should start by developing the interpersonal and collaborative skills of trainees.     

Gliding across the liminal space between counsellor and counselling researcher: Using collective biography practices in the teaching of counselling research methodologies

Aims: Drawing on their engagement in a specific collective biography research project, the co-authors aim to demonstrate how the weaving together of creative story-telling and the theory underlining collective biography practices resulted in an understanding of rhizomatic research methodologies from within the process. This paper aims to demonstrate one way in which research methodologies training can become more firmly embedded within counsellor training courses. Method: A collective of counselling students and a session tutor colleague used collective biography practices to research their memories of traversing the liminal space between ‘counsellor’ and ‘counselling researcher’. Alongside the resulting collective stories, a collaborative review of the research process examined our chosen ways of working within the project. Outcomes: Engaging in collective biography practices resulted in an experiential shift from ‘learning to do counselling research’ to ‘becoming counselling researchers’. Weaving together research processes and researcher reflexivity generated personal and professional learning. Ways in which these research methodologies complement core components of counselling training, within and beyond the teaching of research, were identified. Conclusions: Collective biography practices offer a way of introducing non-arboreal creative research methodologies into counsellor training. Careful consideration of potential challenges surrounding the introduction of these practices is required.     

Scottish secondary school teachers' attitudes towards, and conceptualisations of, counselling

This paper presents the findings of two independent questionnaire studies that examined Scottish secondary schools teachers' attitudes towards, and conceptualisation of, school counselling. Seventy-one teachers in a first study, and 33 teachers in a second study, responded to a range of qualitative and quantitative response-format questions that were designed to elicit their feelings and attitudes towards school counselling, and their notions of what counselling was. Results from the two studies confirm previous findings in this area, suggesting that teachers are generally positive in their attitudes towards counselling; valuing, in particular, the independence and expertise of the counsellor. A small minority of teachers, however, were found to hold strongly negative views towards counselling. Teachers also expressed concerns that students might abuse the counselling service, and that the service might not fully integrate with existing guidance arrangements provided by teachers in schools. The study also found that a high proportion of teachers conceptualised counselling in terms of advice-giving.     

What difference does counselling make? – The perceptions of drug‐using clients on low incomes

Context: This paper reports on a qualitative study looking at the perceptions of clients who use drugs and are on low income. Research suggests that counselling services can experience difficulties in reaching and retaining such clients, and outcomes of counselling can be disappointing. Aim: To learn from clients who had engaged in counselling for over six months what difference it had made to their lives. Method: Grounded theory methodology was used to analyse semi‐structured interviews with six participants. Findings: Findings included changes in the clients’ internal world, their connectedness with society, their familiarity with counselling, and their perception of the relationship with the counsellor. Factors within the counselling process which helped and hindered change were identified. The study documents how participants were able to use counselling to improve their lives.     

Gay men's experiences of therapy

Fourteen gay men were interviewed using a structured interview schedule to explore their experiences of being in therapy. Particular importance was given to their perceptions of how their sexual orientation impinged on the counselling process and how their assumptions about counsellor sexual orientation affected the therapeutic relationship. The limitations of using structured interviews in qualitative research are acknowledged. Some significant findings were made, which were not well documented in the literature, such as the impact on the therapeutic relationship of internalised homophobia within gay men themselves. These findings hold the potential to inform counselling practice with gay male clients. Recommendations are made in relation to both practice and further research.     

Clients talk about their experience of the process of counselling

The purpose of this study was to ascertain clients’ experiences of their counselling. This was done through use of a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in agency located in a mid-sized city in New Zealand. Several themes were identified and discussed in relation to the literature on clients’ perceptions of their own counselling. Specifically, clients were asked to comment on whether their counselling was effective, how much of their improvement was due to counselling versus other factors, the quality of the relationship with their counsellor, specific in-counselling events that were helpful or unhelpful, and how their counselling was terminated. Implications for practice were suggested.     

Writing qualitative research — A gathering of selves

This paper is a reflection and discussion on the integration and personal development that may occur when we use ourselves in heuristic research, particularly in the process of writing. It focuses on my writing about a study I undertook with two of my ex‐clients who are brothers, and their journey towards healing, and on their experience of our counselling relationship as part of that journey. As their counsellor, and the main researcher, my story inevitably intermingles and overlaps with theirs. My ‘selves’ as woman, survivor, client, counsellor, researcher (and numerous other selves) and their selves as survivor, man, client and researcher (and many others) are impacted by the collaborative, experiential nature of the work. Issues faced in the writing of a book about the research (Etherington, 2000), such as self‐disclosure and reclaiming my voice, parallel many of my own issues as a client and my clients' issues.     

Using human inquiry groups in counselling research

The nature of human inquiry groups and their use in counselling research are explored. A key feature of such a group is that the details of what is researched and how it is researched are decided by the group rather than by the researcher alone. Human inquiry groups proceed through a process of cycling. The first stage involves group members gathering together to agree on the nature and the methodology of the research and on the action to be taken. The next two stages involve taking the agreed action and fully experiencing it. Finally, group members reflect together on the research so far, including drawing conclusions and initiating further research cycles. The value of human inquiry as a qualitative methodology for counselling research is considered, including a comparison between the role of the human inquiry researcher and that of the counsellor. The initiator of a human inquiry group may well make use of counselling and group-work skills. Possible problems include role conflict, collusion, how to avoid the human inquiry group turning into a therapy group, and other validity issues. The key question of how to analyse the data produced by such a group is examined. The grounded-theory approach of Glaser and Strauss is considered as one way to analyse human inquiry data. Potential difficulties with such an analysis are explored and the use of a bricolage is presented as one possible solution. Human inquiry is seen to be an important and innovative approach to counselling research which is particularly appropriate for exploratory studies.     

Referring patients to counsellors in primary care: Qualitative investigation of general practitioners’ perceptions

Despite growing evidence of the effectiveness of counselling in primary care, questions arise concerning the role of general practitioners in the referral process. This involves both liaison with counsellors and the management of people who do not wish to see counsellors. Respondents (n=23) in this qualitative study of general practitioners’ perceptions were clear about which patients should be referred to counsellors, based on guidelines. Additionally, these doctors perceived their role and skills as negotiating with their patients about referral to a counsellor, and managing patients who are either waiting to see a counsellor or who prefer not to see a counsellor. These doctors feel inadequately trained in managing this latter group, whose outcome they perceive as unclear. Despite this, respondents accept a role in ongoing support for their patients with consequent training issues for doctors and opportunities for liaison and mentoring by counsellors.     

Specialist counsellors in primary care: The experience and preferences of general practitioners

This paper reports the results of a postal questionnaire, pre-coded by practice, which was sent to all 484 Leicestershire general practitioners. Practitioners who could and who could not refer to an in-house counsellor were compared in terms of their views about counselling provision, both within the practice and by agencies outside, such as mental health teams and specialist counselling services. General practitioners having access to a counsellor belonged to practices which were larger and had fundholding status. No signijicant dafference was found between rural and urban practices in their employment of an in-house counsellor, although those doctors working in rural areas were less likely to see this service as having a high priority. General practitioners without in-house counsellors estimated a referral rate (for counselling) in excess of twice that of the actual rate reported by those with practice counsellors. Those having an in-house counsellor were more likely to agree with statements that emphasized the benefits of this form of provision as against that offered by either mental health teams or specialist counselling services.     

Clients talk about their experience of seeking counselling

The purpose of this study was to explore the help-seeking behaviour of a sample of counselling clients using a questionnaire and follow-up, semi-structured interviews with 20 counselling clients who were seen at a walk-in, affordable counselling agency located in a mid-sized city in New Zealand. Specifically, clients were asked if they had received counselling previously, what efforts they had made to solve their problems before seeking counselling and with what success, why they chose this particular agency, their initial impression of their relationship with their counsellor, and their reactions to participating in the research. The data were analysed to ascertain themes associated with their decision-making and choices. Findings were discussed in relation to the literature on seeking counselling, how clients determine their need for counselling and the process they go through in deciding when and where to get it. Implications for counsellors are discussed.     

Responses to Marriage Counselling

The experiences of clients who received marital counselling from trained volunteer marriage guidance counsellors were investigated. Fifty-one clients from 42 marriages were interviewed and questioned about why they chose the agency, what expectations they held, what happened during counselling, how they felt about the counsellor, and what if anything was achieved through counselling. They were also asked how they had fared since. Rating scales were used after the interview to evaluate satisfaction with counselling, benefit from counselling, aspects of the counselling relationship, etc. The clients were also asked to do a card-sort of statements about counselling to determine what aspects had been valuable and disappointing. Some of the preliminary results of the study are presented and discussed.     

Counselling marginalised young people: A qualitative analysis of young homeless people's views of counselling

Aims: This study explored young homeless people's views of counselling, with a view to considering how the counselling profession can better meet their needs. Method: A small scale qualitative research project was undertaken in two residential projects for young homeless people. Data was gathered through focus groups and then analysed using grounded theory. Findings: The study revealed a lack of trust in counsellors and counselling, as well as a dislike of the counselling process. Implications for practice: Some suggestions for how best to work with this particularly marginalised client group are discussed. These include ways of making counselling more engaging, raising the profile of the counsellor in the young person's environment and having an awareness of the needs specific to at‐risk young people.     

Buying into the profession: looking at the impact on students of expert videotape demonstrations in counsellor education

From analysing qualitative questionnaires, a group interview, and instructor interviews this study explores the impact of viewing expert demonstration videotapes on students’ learning processes, their identification as counsellors, and understanding of the counselling profession. Commonly, students selectively choose what they see and how they see it. They describe a process of ‘shopping’ and ‘buying into’ specific theoretical, practical, and professional perspectives. Additionally, students give suggestions for the most helpful use of expert demonstration videos in counsellor education. The paper concludes with key questions for further study.     

'If you don't want to tell anyone else you can tell her': young people's views on school counselling

The aim of the research was to assess the views of young people about school counselling. In total, 415 pupils from five secondary schools took part in the survey. A smaller number of these pupils took part in focus groups (n=9) to explore their views in more depth. In general, the young people seemed to value having a school counsellor. Most were aware of the school counselling service, although a substantial number (21%) indicated a lack of awareness. For many who were aware, their knowledge of the service was limited. Just over one third of the pupils stated that they would go to see the school counsellor, and girls were more likely to state this than boys. The confidentiality of the service was perceived to be one of the benefits. However, this was also reported to be a hindering factor—the concern that it may not, in fact, be confidential. Two other main reasons for not accessing the service were the counsellor being a stranger and (for boys in particular) a concern about other people finding out (associated with the social stigma of going for counselling). Suggestions to improve the school counselling service included a room in a discrete location, better promotion of the service, more counsellors or a full-time counsellor, and ways to get to know the counsellor better. Those responsible for developing and managing school counselling services should consider these suggestions.     

What makes a good counsellor? An analysis of ways in which counsellor trainers construe good and bad counselling trainees

As part of an investigation into criteria used by counsellor trainers to distinguish between good and bad students of counselling, experienced counsellor trainers were asked to complete a repertory grid. Each trainer was asked to list five good counsellor trainees and five not so good or bad counselling trainees they had worked with, as elements for the grid. Repertory grid forms were provided by the researcher with spaces for ten constructs which were elicited from the trainers in the standard triadic manner. For each elicited construct subjects were asked to rate each trainee on a five point scale. Twenty-seven correctly completed grids were collected. The 262 constructs elicited were conflated into 22 semantically similar categories by the researcher and independent raters. The data was subjected to statistical analysis using the Statistical Package for the Social Services (SPSS). Overall the constructs that were most frequently used in describing trainees were open-closed, personable/aloof, secure-insecure, professionally skilled-unskilled. The mean differences for scores of good and bad trainees for each of the 22 conflated constructs were calculated. The greatest mean difference related to professional competence. The 22 conflated constructs were subsumed into three categories, and the mean of the difference between ratings for good and bad trainees within each category was calculated. Counselling related competence showed the greatest mean difference. Implications for counselling course curricula and the selection and assessment of counsellor trainees are discussed.     

How person-centred counselling trainers understand and experience their role in the current British context

This article reports the findings of a qualitative study into the experience of person-centred training from the viewpoint of the trainer. Interpretative phenomenological analysis was the adopted approach. The researcher conducted a series of in-depth semi-structured interviews with five person-centred trainers with experience across a range of settings. The findings demonstrate the commitment of person-centred trainers to a relational approach with the facilitation of individual potential at its heart. The intrinsically rewarding nature of the role is highlighted alongside its substantial demands. Participants demonstrated a primary identification with themselves as counsellor trainers rather than academics and some lack of reconciliation with current developments within counselling.     

A follow-up study of new users of a university counselling service

For many students the demands of a university course, often coupled with financial and relationship difficulties, create circumstances where counselling or specialist psychiatric support are needed. Few published studies exist of these services. A follow-up study of new users of the University of Cambridge Counselling Service during the course of the 1993/94 academic year is reported. The study aimed to describe morbidity levels and to identify the determinants of change in students' mental health status. Data were obtained from two initial questionnaires: one completed by each student at the time of their initial consultation; the second by the counsellor completing an assessment consultation. About one year following their first assessment, students were asked to complete a further questionnaire. The clear demonstration in this study of depression and anxiety symptoms, as dominant features for many students at their assessment consultation, suggests that training to improve counsellor recognition of such symptoms and of their knowledge of the effectiveness of available therapeutic approaches would be valuable. Such training should also provide guidance on when to refer students to other professionals.     

Counselling students' views and concerns about weeping with clients: A pilot study

This study examines counselling students' concerns and views about a phenomenon that has received little attention in the counselling literature: the counsellor weeping during a session with a client. Over 20 per cent of the counselling students who were surveyed reported being concerned about weeping in session with clients. However, the majority of students believed, to varying degrees, that weeping with clients could facilitate the therapeutic process. This paper sheds light on this unexplored dimension of countertransference, and has implications for those involved in providing counsellor training.