Counsellors perceptions of adolescence

School mental health professionals' attitudes toward their potential client populations can determine what strategies they apply vis-à-vis their clients. Therefore, it is important that they be aware of their personal orientations. In this vein, the present study investigates, through both quantitative and qualitative methods of collection and analysis of data, the perceptions Israeli secondary-school counsellors have of adolescence. Questionnaires filled by 199 counsellors showed that, in general, counsellors have a favourable view of adolescents and do not perceive adolescence as a 'difficult stage'. Counsellors also believe that they are perceived positively by their adolescent students. Interviews conducted with 41 counsellors (a group randomly selected from the initial sample of counsellors) revealed a more complex view of adolescence. The interviewed counsellors identified five type of adolescents: the drive-oriented adolescent, the intellectually-oriented adolescent, the grouporiented adolescent, the community-oriented adolescent, and the isolated adolescent. The study also explores counsellors' opinions regarding each of these types' main characteristics, the leading reasons that may prevent adolescents from approaching a counsellor, and the considerations that may influence them to independently refer to a counsellor. Implications for school mental health professionals are discussed.     

Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

Aims: To gain insight into counsellors' experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors' perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n = 8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.     

Measuring counsellor theoretical orientation

Previous studies of counsellors' and psychotherapists' theoretical orientations have suggested the importance of two superordinate dimensions of beliefs about therapeutic practice: an analytical-experiential dimension and an objective-subjective dimension. A 40-item measure was developed which tapped both these. A study involving 132 counsellors found evidence that the Counsellor Theoretical Position Scale is a reliable and valid measure of important aspects of theoretical orientation to counselling practice.     

Counselling in organisations: What is the experience of the lone counsellor?

Aims: To explore and understand lone counsellors' experiences of working in organisations, and to indicate means of enhancing this. Method: Semi-structured interviews were conducted with nine participants and subjected to a qualitative, grounded theory analysis (Glaser, 1992; Glaser, 1998). Findings: Lone counsellors felt lonely, isolated and stressed in the workplace. The ‘lone battling’ behaviour adopted in an attempt to seek acceptance within the organisation and meaningful relationships with likeminded others in the counselling community was only partially successful. The lone counselling experience is understood to be a product of the tension inherent in organisational dynamics. Discussion: The findings help to confirm the belongingness hypothesis proposed by Baumeister and Leary (1995) that states that the need to belong is a fundamental motivation. Implications: The relevance of these findings to the training and employment of counsellors and other lone workers is discussed as well as areas for further research.     

The challenge of becoming an integrative counsellor: The trainee's perspective

Aim: Integrative therapeutic practice is commonplace within the UK. Counsellors and psychotherapists increasingly report working in this way and numerous training courses have developed which advocate such practice. Despite its popularity, researchers have paid little attention to the impact that such training has upon students. This study therefore explores newly qualified counsellors' reflections of undertaking professional training in integrative counselling. Design: Newly qualified counsellors were invited to take part in a focus group to discuss their training experiences. Two groups were held involving a total of seven people. The data generated was analysed using Grounded Theory. Findings: The core-category ‘The challenge of becoming an integrative counsellor’ was identified. Embedded within this were four sub-categories: (1) ‘training issues’, (2) ‘applied issues’, (3) ‘the development of an integrative theory and identity’, and (4) ‘the impact of integrative training post qualification’. Key findings include the willingness of trainees to tolerate theoretical ambiguity and the discomfort that surrounded not belonging to a pure paradigm community. Discussion: Recommendations are made that trainers and practice supervisors are mindful of the distinct struggles that integrative trainees encounter. Additionally, in response to the isolation that some trainees report, greater use of peer support networks is encouraged.     

Counsellors' experiences of working with suicidal clients: An exploratory study

Counselling is increasingly available in a wide variety of contexts, including mental health and psychiatric services. As a consequence, counsellors increasingly work with clients who present with suicidal ideation, expressing either suicidal thought and/or intent in the counselling session. This paper describes an exploratory study that examined the experience of counsellors when working with suicidal clients. The paper considers counsellors' behavioural, cognitive and emotional responses to such suicidal expression, both on a personal and professional level. The research employed semi‐structured interviews. A constant comparative method was used in analysing the transcribed interview text. Results suggest that counsellors experience a range of responses when their clients express suicidal thought, including fear, anxiety, anger and professional impotence. The interviewees also expressed self‐doubts about their professional competence. In addition, they identified the threat of litigation for negligent practice and the lack of confidence in appropriate risk assessment approaches as significant causes for concern. The implications for further research, and practice, are discussed.     

The relationship between counsellor interpersonal skills and the core conditions of client-centred counselling

The present study aimed to determine whether there was a systematic relationship between Rogers'(1957) core conditions of empathy, acceptance and genuineness, and counsellors' use of specific behaviours or skills which have been isolated for training. Video recordings of 12 counsellors' performance in 'naturalistic' counselling interactions were analysed. Counsellor, client and judges' ratings of the core conditions were obtained. Skill assessment included molar ratings of eight skill areas and molecular measures of 29 behaviours. The results indicated that there were few significant relationships. It is concluded that there is a discrepancy between specification of the skills or behaviours which are thought to communicate the core conditions and those which have been empirically demonstrated to do so. Implications for counsellor training and proposals for future research are discussed.     

Between the idea and the reality: A study of the counselling experiences of bereaved people who sense the presence of the deceased

There have been many theories of the process of loss and bereavement, from Freud, to the present day. Early theories of bereavement described a process which, following various stages and associated tasks, ended at the relinquishment of the bond to the deceased. In more recent years theories have taken different directions, identifying how bereaved people re‐learn life, recreate biographies, and continue relationships to the deceased. Some research studies of bereavement have investigated the counsellors’ perspective, but there are very few studies of the client's experience and most studies have focussed on outcomes of counselling. This qualitative study, using semi‐structured interviews, provides an insight into the bereaved client's perspective on the content and process of their counselling experiences. Taking as its focus the client's sense of the presence of the deceased, this study aimed to identify whether or how counsellors facilitate exploration of this experience and which theories they use in client work. The main finding is that 80% of the counsellors were not perceived by participants to have worked with them satisfactorily in relation to their sense of presence of the deceased or in relation to the story of the death itself.     

‘She's not going to leave me' – counsellors' feelings on ending therapy with children

This study sought to explore the impact of ending therapy on counsellors working with children in schools. Five counsellors were interviewed and their responses were analysed using interpretative phenomenological analysis. Four master themes emerged, one of which, empathic identification, is the focus of this paper. The findings of this study suggest that the counsellor's experience of ending therapy can evoke long-term powerful emotions.     

The impact of enhanced incentives on vocational rehabilitation outcomes for dually diagnosed veterans

This study evaluated the efficacy of adding contingency management techniques to vocational rehabilitation (VR) to improve treatment outcome as measured by entry into competitive employment. Nineteen dually diagnosed veterans who entered VR in the Veterans' Administration's compensated work therapy (CWT) program were randomly assigned to CWT (n = 8) or to CWT with enhanced incentives (n = 11). Over the first 16 weeks of rehabilitation, those in the incentives condition could earn up to dollar 1,006 in cash for meeting two sets of clinical goals: (a) remaining abstinent from drugs and alcohol and (b) taking steps to obtain and maintain a competitive job. Results indicate that relative to participants in the CWT-only group, those in the incentives condition engaged in more job-search activities, were more likely to remain abstinent from drugs and alcohol, were more likely to obtain competitive employment, and earned an average of 68% more in wages. These results suggest that rehabilitation outcomes may be enhanced by restructuring traditional work-for-pay contingencies to include direct financial rewards for meeting clinical goals.     

Cruise ships and kayaks: welfare and rehabilitation approaches for women with disabilities in poverty

Women with disabilities have low employment rates and about one-third live in poverty. They represent half of the population using either services of the vocational rehabilitation (VR) system or the welfare system, and many use both. Although both systems have made gains in improving their employment status, neither comprehensively addresses the needs of this population. Welfare policy has encouraged state level innovation and moved large numbers of people into employment in as little as five years. State welfare agencies offer a range of services specifically addressing the needs of families with children. VR agencies have decades of specific experience assisting people with disabilities gain employment. Welfare reform has been the cruise ship moving large numbers of people across an ocean. VR agencies have been the kayak builders designing specialized small craft to move specific people along tributaries. What can they learn from each other? Copyright © 2002 John Wiley & Sons, Ltd.     

Children's understanding of drivers' intentions

To become more skilled as pedestrians, children need to acquire a view of the traffic environment as one in which road users are active agents with different intentions and objectives. This paper describes a simulation study designed to explore children's understanding of drivers' intentions. It also investigated the effect of training children's sensitivity, through peer discussion and adult guidance, to the cues by which drivers signal their intentions. Results confirmed that children's ability to accurately predict drivers' intentions improves with age and that sensitizing children through training to the options for action available to drivers when signalling a manoeuvre improves their accuracy in predicting drivers' intentions. Training was also found to shift children's focus from contextual infrastructural features of the traffic environment (e.g. traffic signals, stop signs) by which to judge drivers' likely intentions to the explicit cues that drivers use to signal their imminent actions (e.g. slowing down, moving into the kerb). Training on the simulation was also shown to transfer to practical decision making at the roadside.     

The client as a self‐aware agent in counselling and psychotherapy

Clients' recollections of their experiences of counselling and psychotherapy were stimulated using the technique of Interpersonal Process Recall. Their reports were analysed in terms of the grounded theory method of qualitative research. The analysis resulted in the interpretation that the core category of their experience is clients' reflexivity, or self‐awareness and agency flowing from it and returning to it. The focus of this paper is directed at the client's reflexivity in response to the counsellor's operations. Its organizing theme is that how clients respond to counsellors' operations depends on what clients desire and what they feel they can say safely. Particular desires arise from an over‐arching desire either to enter into or avoid inner experience. Moreover, the relation with self is influenced by the relationship with the therapist. This complexity makes it difficult to predict responses to non‐directive and directive counsellor performances alike. Vignettes selected from the participants' reports illustrate the theme. Implications for the practice of counselling and psychotherapy are discussed.     

Virtual reality as an immersive projective and autodriving advancement technique

The COVID-19 lockdown posed challenges for traditional qualitative researchers, as well as opportunities for innovative qualitative research. While online interviews and focus groups via video conferencing platforms were the most widely used methods, Zoom Fatigue also occurred, hampering some participants' experiences and eventually impacting data quality. Incorporating virtual reality (VR) was one possible solution. This study explores the experiences and involvement of family participants in a qualitative research study using VR during the COVID-19 pandemic lockdown. The research aims to assess the impact of VR on data quantity and quality, as well as the depth of insights compared to traditional methods without VR. The study employs VR roleplay and autodriving methods to elicit family participant engagement. The findings suggest that the application of VR in autodriving improves data quality and quantity while also making the research process more enjoyable for participating parents and children. The results indicate that VR holds significant potential for advancing qualitative research methodology, especially for previously underrepresented groups such as children.     

Counsellor-delivered HIV risk reduction intervention addresses safer sex barriers of people living with HIV in KwaZulu-Natal,South Africa

This study developed an HIV risk reduction intervention for people living with HIV (PLWH) obtaining care at primary healthcare clinics in KwaZulu-Natal, South Africa by (1) conducting elicitation research to understand the dynamics of risk behaviour among PLWH, (2) modifying an existing HIV risk reduction intervention based on research findings and (3) conducting a pilot study to evaluate feasibility, acceptability and fidelity of the modified intervention implemented by trained lay counsellors at a rural clinic in KwaZulu-Natal. A total of 61 healthcare providers and 77 HIV+ patients from four primary healthcare clinics participated in 14 focus groups and 20 individual interviews to identify informational, motivational and behavioural skills (IMB) factors contributing to PLWH's sexual risk behaviour. Elicitation research findings were incorporated into a revised version of Options for Health, an evidence-based risk reduction intervention for PLWH in clinical care. In a 5-day training, lay counsellors learned strategies to address IMB barriers to safer sex identified in elicitation research. The revised intervention, which was implemented by six counsellors with 39 patients, was feasible to implement, acceptable to patients and counsellors, and implemented with good fidelity. This study makes an important contribution towards development of a theory-based HIV risk reduction intervention for PLWH linking prevention with treatment in South Africa.