Counselling psychology in the United Kingdom

Counselling psychology within the UK has grown over the last three decades, adapting to many changes in the field of applied psychology, whilst remaining true to its core values and humanistic origins. The identity of counselling psychology is strongly rooted in a relational stance and applied psychology, where attention to psychological formulation is given to improve psychological functioning and well-being. This article outlines a brief history of counselling psychology in the UK, the training process, credentialing and looks at some important challenges and future directions for counselling psychology in the UK. A proportion of the members from the British Psychological Society’s division of counselling psychology (DCoP, N = 148) took part in the study. Participants provided demographic, training, employment, workplace and career pathway information obtained through an online questionnaire distributed to all DCoP members. On the whole, DCoP members are working in a variety of areas within the UK and the findings of this article contribute to the international study comparing counselling psychology across the globe.     

Counselling in Medical Settings

The slow development of counselling as an alternative to traditional treatment within the medical model is described. Counselling in medical settings has its roots in the work of the Marriage Guidance Council and the influence of Balint towards psychotherapy. 10-30% of all consultations in general practitioners' surgeries are related to emotional distress, yet the adoption and rise of counselling is more patchy than widespread. The factors which have hindered its expansion in the past are discussed, and it is concluded that its development in the future will depend largely upon pronounced changes in public health policy.     

Counselling foreign students: A review of strategies

This article focuses on the unique counselling needs of foreign students as reflected from a review of the literature. As more and more students from developing countries opt to further their education in the West, knowledge about counselling foreign students is of increasing interest. Distinctive aspects of foreign student clients and the typical problems faced by them are described. The issues which need to be addressed and the competencies which need to be developed in order to effectively counsel foreign students are discussed. Finally, specific strategies for counselling foreign students are suggested in the context of general guidelines for cross-cultural counselling.     

Counselling Supervision: The British context

Counselling/psychotherapy supervision is on the verge of a professional breakthrough in Britain today. Training courses are emerging, accreditation for supervisors is in progress and a Code of Ethics for Supervisors is finalised. Yet supervision is still little understood. There are few agreed definitions and certainly no agreed tasks, roles, or even goals of supervision. Conflict still abounds about whether it is more akin to therapy than to education, about whether or not it shold be evaluative, and about what areas of counselling it should cover. Supervisors are poorly trained in supervision and areas such as the legal implications and responsibilities of supervision not clear and often not even considered important. What research has been done is confined largely to United States and few attempts have been made to apply findings to Britain, e.g. how valid in Britain is the current research on Developmental Models of supervision which outline the stages through which counsellors in training travel.

Supervision is still tied to counselling theory despite its efforts to become a discipline on its own. Most supervisors in Britain seem to apply their theory of counselling to supervision setting. However, some of the conflicts are being faced and some questions raised about the future of supervision, about the kind of relationship involved, about its relationship to counselling. This article raises some current issues in the field and asks the kinds of questions that need answering before we are able to talk about a British understanding and application of counselling supervision.     

Counselling in primary care: a systematic review of the research evidence

Counselling in primary care in the UK is expanding rapidly, and its evidence base needs to be established. We present the rationale for conducting controlled trials of counselling in primary care, and suggest that a systematic review of controlled trials of counselling in primary care is timely. We describe the process of conducting the review in accordance with Cochrane Collaboration guidelines. The review aimed to assess the effectiveness and cost-effectiveness of counselling in primary care, by systematically reviewing cost and outcome data from randomised controlled trials and controlled patient preference trials of counselling interventions, for patients with psychological and psychosocial problems considered suitable for counselling. The search strategy, inclusion and exclusion criteria, data collection and data analysis are described. The results of the review are presented. The review included only controlled trials of counselling in which counsellors accredited by the British Association for Counselling (or equivalent) provided non-directive counselling in primary care. Four trials met the inclusion criteria. Results indicated that patients who receive counselling show a modest but significant improvement in symptom levels compared with those who receive GP care. Levels of satisfaction with counselling are high. There is very tentative evidence to suggest that counselled patients are more likely to be considered recovered than usual GP care patients. There is limited information about the cost-effectiveness of counselling. We conclude by reflecting upon the results of the review and their implications for counselling research.     

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.     

AIDS Counselling: Clinical Application and Development of Services

The reasons for the provision of AIDS counselling services, and the ways in which they have developed, are described. The role of the counsellor both in medicine, and in the field of AIDS/HIV infection, is outlined. The psychosocial difficulties accompanying this illness are reviewed. Stress is placed on the need to consider not only the client, but also their sexual partners, family, friends, colleagues and even other members of the health-care team. Further investigations need to be carried out to clarify where AIDS counselling services fit with other medical and paramedical services.     

Peer Group Counselling with Bereaved Adolescents

An experiment is described which aimed to help bereaved teenagers through peer group counselling, and also to examine the related issue of how reliably we can measure the effectiveness of such counselling. This involved a systematic approach to the subjective impressions of participants, and also used objective measurement techniques. Subjects perceived the group counselling sessions to have had a high value, and certain consistent trends were revealed concerning participants' previous experience of their bereavement and concerning the medium-term effects of adolescent bereavement. Statistical analysis of the objective tests paralleled this with improvements in several areas, though the extent of the statistical significance of those improvements is debatable. Recommendations are made concerning the implications for the pastoral care of bereaved pupils in schools.     

The Evaluation of Student Counselling: A Review of the Literature 1962-86

A critical review of studies examining the efficacy of student counselling is presented, together with suggestions for how the design of such research might be improved. Complementary investigations of client and employer attitudes towards and expectations of student counselling services are also described. The need to evaluate student counselling in the face of economic cutbacks is discussed.     

Training and Research in Counselling

Formal counselling training in Britain began with the preparation of school counsellors in universities and relied largely upon American models. Early courses were highly didactic but over the last decade practical and experiential aspects have taken precedence. Basic counselling training has now been extended into the preparation of many workers, voluntary and professional. Counselling research also had academic origins, but has broadened to include many different work settings. Much of the published research has been in the form of surveys of counselling services, but some detailed studies of process are noted. There is a need for research to be increased, and the gap between research and practice shortened, if counselling is to demonstrate its relevance to contemporary needs.     

Transformation in Counselling

The view is put forward that counselling appears to be undergoing a transformation which renders the old distinction between counselling and therapy no longer meaningful or practical. This transformation reflects the psychic backdrop of our times; it has come about because the needs of people seeking help, as well as the needs of those counselling, have altered and developed. Increasingly, clients are acknowledging the need for radical change which involves exploration of all levels of their being. This transformative work, a moving across inner barriers and coming into wholeness, necessarily involves active awareness of spirit. Thus it is no longer possible to be a client-centred counsellor without being willing to address the spiritual dimension ofhuman-beingness.     

Counselling psychology in primary health care: A review

This paper reviews the development of counselling psychology within the field of primary health care. Issues discussed include liaison between counselling psychologists and other professionals, evaluation of treatment in primary care, family therapy in general practice and general practitioners’ skills in counselling. The need for training and evaluation of counselling are discussed and suggestions are made for further research.     

Counselling psychology in South Korea

Counselling psychology (CP) in South Korea has grown tremendously as it establishes its unique niche in the mental health profession. Diverse practice under the roof of CP is a strength as well as a weakness. In this paper, we describe the characteristics of CP in South Korea in terms of history, credentialing, the service delivery system, organizations, training, distinctive features from other adjacent areas, core values, and the profession’s unique challenges and future directions. Future tasks include the establishment of clear professional identity, achievement of a governmental licensure system, a nationwide accreditation system, development of Korean-specific ways of counselling, protocols for trauma, and increased accessibility.     

Counselling in the United Kingdom: past, present and future

We chart the development of counselling in Britain since the Second World War through to the present and speculate about possible directions counselling may take in the future. Our major, but not exclusive, focus is on counselling as a developing profession and the particular role that the British Association for Counselling has played in this development. To this end, we consider some of the professional issues that have preoccupied practitioners in the field and those that may do so in the future. Thus, amongst others, we consider the relationship between counselling and psychotherapy, the costs and benefits of counselling's increasing visibility in British society, the role that supervision has come to play in the maintenance of professional standards, the debate that has surrounded the issue of counsellor accreditation/registration, the development of standards and ethics and the tension that exists between the relational and technical aspects of counselling. Counselling does not exist in a vacuum, and this is seen most strikingly in the speculations that we make about future developments of counselling. Thus, for example, we argue that counselling will have to grapple with the increasing emphasis that society places on the accountability of human services and with the inexorable progress occurring in the area of technological development. We note that counselling's response to these significant trends will have to be made against the backdrop of the continuing dissolution of barriers between previously distinct areas of human knowledge .     

Guidance and Counselling in Further and Higher Education

The publication in 1973 of Student Counselling in Practice signalled a new phase in the development of both careers and counselling services in the tertiary sector. The emergence of the professional careers adviser in higher education is described alongside the key role of the Association of Graduate Careers Advisory Services. The gradual professionalisation of student counselling is shown to have taken a different form, as a result of the policies of the Association for Student Counselling with its insistence on role definition and the accreditation of practitioners. Developments in further education are briefly reviewed, and a final section considers the present situation and possible future trends.     

Genetic Counselling for Psychiatric Disorders: Accounts of Psychiatric Health Professionals in the United Kingdom

Genetic counselling is not routinely offered for psychiatric disorders in the United Kingdom through NHS regional clinical genetics departments. However, recent genomic advances, confirming a genetic contribution to mental illness, are anticipated to increase demand for psychiatric genetic counselling. This is the first study of its kind to employ qualitative methods of research to explore accounts of psychiatric health professionals regarding the prospects for genetic counselling services within clinical psychiatry in the UK. Data were collected from 32 questionnaire participants, and 9 subsequent interviewees. Data analysis revealed that although participants had not encountered patients explicitly demanding psychiatric genetic counselling, psychiatric health professionals believe that such a service would be useful and desirable. Genomic advances may have significant implications for genetic counselling in clinical psychiatry even if these discoveries do not lead to genetic testing. Psychiatric health professionals describe clinical genetics as a skilled profession capable of combining complex risk communication with much needed psychosocial support. However, participants noted barriers to the implementation of psychiatric genetic counselling services including, but not limited to, the complexities of uncertainty in psychiatric diagnoses, patient engagement and ethical concerns regarding limited capacity.     

Counselling Psychology in Japan

Les caractéristiques du conseil psychologique au Japon ont été passées en revue selon les points-de-vues suivants: (1) l'histoire du conseil psychologique. (2) le conseil psychologique aujourd'hui, (3) le conseil psychologique comparé au psychologue clinicien. (4) l'avenir du conseil psychologique, et (5) le conseil psychologique appliqué au, conseil d'etudiants. Au Japon, le conseil psychologique est encore jeune, si Ton en juge par sa familiarité chez les professionnels comme chez les non-professionnels, probablement autant à cause des caractéristiques nationales des japonais que du système scolaire. Il semble important que le conseil psychologique sauvegarde son identitéà I'intérieur des disciplines de la psychologie appliquée et/ou de la psychologie de la santé.
The outlook for counselling psychology in Japan has been reviewed from the following viewpoints: (1) the history of counselling psychology, (2) counselling psychology today, (3) counselling psychology compared with clinical psychology, (4) the future of counselling psychology, and (5) counselling psychology applied to student counselling. It is found that counselling psychology in Japan is still young in terms of its familiarity to both professionals and non-professionals, probably because of the national characteristics of the Japanese as well as the certification system. It seems to be important for counselling psychology to secure its identity within the discipline of applied psychology and/or health psychology.     

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 Psychology in Canada

Counselling psychology in Canada has experienced tremendous growth and greater recognition within the last 30 years. However, there is little empirical research on the practice of counselling psychology in Canada and the characteristics of Canadian counselling psychologists. We administered a 74 item questionnaire to 79 counselling psychologists who were members of the Counselling Psychology Section of the Canadian Psychological Association, achieving a 35.4% response rate. The survey asked various questions organized under the headings of: Background Information, Theoretical Orientations, Professional Activities, Training and Career Experiences, and Future. Overall, these Canadian counselling psychologists seem to see the discipline as moderately different from clinical psychology and from counsellor education, and are largely satisfied with their choice of career in counselling psychology. Results further indicate that independent practice is the most common work-setting and that respondents spend a large share of their time providing individual, non-career related, counselling/psychotherapy of primarily a rehabilitative/treatment-oriented nature. A strengths-focused approach was also highly valued by the sample. The development of the field, distinctive characteristics of Canadian counselling psychology, the place of counselling psychology in the Canadian health care delivery system, credentialing, professional organizations, education and training issues, allied professions, opportunities for the field, and threats to the field are also discussed.