Factors affecting self-referral to counselling services in the workplace: a qualitative study

The benefits of psychological support in the workplace (also known as workplace counselling) are well documented. Most large organisations in the UK have staff counselling schemes. However, it is unclear what, if any, factors affect employee decisions to use such schemes. This study has used a qualitative methodology to explore the reasons that make employees use workplace counselling. Eleven employees of a university in the north of England who had used the staff counselling service of their employer took part in the study. The employer had two schemes available: an internal staff counselling service and an external Employee Assistance Programme (EAP). A semi-structured interview was used with each participant and grounded theory techniques were used to analyse the interviews. The analysis resulted in the construction of a model of psychological help-seeking in the workplace. The main findings indicate that most participants were motivated to use their employer's counselling service by their prior positive experiences of similar or other type of mental health services. Other encouraging factors were: recommendation of service by others, a supportive environment and trust in the confidential ethos of the service. Conversely, negative preconceptions of psychological help-seeking and a perception of the employing environment as unsafe were shown to have been discouraging factors. The study concludes with suggestions for practice and for further research.     

Emotional intelligence levels and counselling skills of prospective psychological counsellors

This research aimed to determine the correlation between emotional intelligence (EI) and counselling skills of Turkish prospective psychological counsellors and to investigate differences in both EI and counselling skills in terms of sex, previous experience of group studies, and class levels. Within a correlational pattern, the sample of the study comprised a total of 349 prospective psychological counsellors; 266 females (76.2%) and 83 (23.8%) males. The data were collected via a Personal Information Form, Bar-On Emotional Quotient Inventory ? and Microcounseling Skill Discrimination Scale?. The results indicated a significant negative correlation between EI and emotional reflection and general counselling skills; no significant correlation between EI and content reflection.     

An exploration of an integrated counselling and coaching approach with distressed young people

This mixed methods study explored the effectiveness and experience of an integrated counselling and coaching approach with young people. An effectiveness study allocated 80 young people aged between 13 and 25 years from four Youth Information Advice and Counselling Services centres in England to two groups: an integrated counselling and coaching group, based on the Personal Consultancy (PC) model, and a humanistic counselling group. Self-report measures of distress were administered at baseline and endpoint. Findings of the quantitative analysis showed that although baseline distress levels between groups were equivalent, post-intervention levels were significantly lower in the integrated group. Interpretative Phenomenological Analysis of qualitative experiences from five young people from the integrated group explored possible reasons for these results. Five master themes emerged: making sense of past, present and/or future, developing a sense of agency, management of affect, enhancing interpersonal relationships and development of self. Findings indicated that young people responded well to the integrated treatment; attending to intra-psychic issues alongside their developmental challenges seemed to have a beneficial effect on their sense of agency in particular. In conclusion, PC may be an effective means of reducing distress in young people.     

Ten principles of counselling: Grounded theory in a mixed methods research project

This grounded theory (GT) study is part of an extensive mixed methods research project to develop general principles for counselling. Nine hundred counselling protocols were examined. The material is characterised by a quantitative amount of data with a qualitative character. The research is based on the systemic-constructivist research paradigm. The variety of perspectives is an important aspect of the work. Therefore, it is important that the entire research process with GT takes place in exchange with other research settings in order to minimise the limitations caused by the perspective of the researchers. During the research process, there was an intensive examination of GT in order to adapt it to the research project. By using the GT to analyse the extensive qualitative material, the actions of the counsellors were observed and 10 counselling principles were developed. This article presents the research process and the findings.     

Emotional health,support, and self‐efficacy in young adults with a history of language impairment

Children and adolescents with language impairment (LI) are at risk of emotional health difficulties. However, less is known about whether these difficulties continue into adulthood for this group, or about the potential role of environmental resources (e.g., social support) or internal resources (e.g., self‐efficacy). This study investigates emotional health in 81 adults with a history of developmental LI (aged 24) compared with 87 age‐matched peers (AMPs) using Beck Inventories. Social support and self‐efficacy measures were examined as predictors. The results were fourfold: (1) adults with LI had higher levels of emotional health problems; (2) whilst the availability of social support was similar across groups, people with LI received more help from others compared to peers; (3) social support was not significantly related to emotional health in those with LI – in contrast, for AMPs, uptake of support indicated poorer emotional health; (4) self‐efficacy was the strongest predictor of emotional health in both groups and fully mediated the relationship between language and emotional health (no moderation by group). This cross‐sectional study has implications for concurrent factors that might affect emotional health outcomes for children and young people with and without LI.     

Emotional face recognition in autism and in cerebral visual impairments: In search for specificity

Autism spectrum disorder (ASD) is characterized by difficulties in the social domain, but also by hyper- and hypo-reactivity. Atypical visual behaviours and processing have often been observed. Nevertheless, several similar signs are also identified in other clinical conditions including cerebral visual impairments (CVI). In the present study, we investigated emotional face categorization in groups of children with ASD and CVI by comparing each group to typically developing individuals (TD) in two tasks. Stimuli were either non-filtered or filtered by low- and high-spatial frequencies (LSF and HSF). All participants completed the autism spectrum quotient score (AQ) and a complete neurovisual evaluation. The results show that while both clinical groups presented difficulties in the emotional face recognition tasks and atypical processing of filtered stimuli, they did not differ from one another. Additionally, autistic traits were observed in the CVI group and symmetrically, some visual disturbances were present in the ASD group as measured via the AQ score and a neurovisual evaluation, respectively. The present study suggests the relevance of comparing ASD to CVI by showing that emotional face categorization difficulties should not be solely considered as autism-specific but merit investigation for potential dysfunction of the visual processing neural network. These results are of interest in both clinical and research perspectives, indicating that systematic visual examination is warranted for individuals with ASD.     

Adventure based counselling,individual counselling and object relations: a critical evaluation of a qualitative study

Adventure based counselling is a short-term experiential psychotherapeutic approach, which utilises adventurous activities and being in natural environmental in order to facilitate therapeutic change in clients. The present paper critically appraises the results of a qualitative study that investigated how clients with self-reported anxiety and depression experienced participating in an innovative counselling intervention with combined individual counselling with such an adventurous outdoor transaction. Interpretative Phenomenological Analysis, as described by Smith and Osborn (2008), was used in order record and analyse the experiences of four male and six female students who were treated at the Teesside's University Counselling Service. Interviewees perceived the counselling sessions as offering a safe therapeutic space within which they could unveil their anxieties and achieve inner healing, whereas the outdoor transaction as providing an experiential venue for achieving personal change. Interviewees felt that without the outdoor transaction the therapeutic significance of the counselling process would not have reached its full potential. Likewise, without the individual counselling, the outdoor transaction would just have an entertaining event and not a venue for personal change. These findings are discussed in relation to object relations theory.     

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.     

Psychological support for people with dementia: A preliminary study

Aim/Purpose

Evidence suggests nonpharmacological therapies could improve quality of life in people with Alzheimer's disease (Olazaran et al., 2010). This study aimed to explore attitudes to, and acceptability of, psychological support for people with mild dementia, from their perspective.

Design/Methodology

Semi‐structured interviews were conducted with five people identified from secondary care services. Questions concerned the experience of being diagnosed, experience of support services and their opinion of alternative support options. Interviews were audio‐recorded, transcribed and analysed using thematic analysis.

Results/Findings

Three main themes were identified: loss, coping mechanisms and support. Loss of physical abilities was associated with loss of identity and place in the community. Coping mechanisms included asserting control, and growth and development, including engaging in new activities or using humour. Individual needs and preferences were key to effective support. Social aspects of support and opportunities to talk about their feelings were valued by participants. Counselling, mindfulness and group‐based activities, including walking and gardening, were viewed positively. Support from admiral nurses or specialist nurses tended to be viewed in terms of physical health needs, and most needed in later stages of dementia.

Research Limitations

Limitations include the small sample size, potential inaccuracies acknowledged by participants regarding recollections of events and researcher bias in hoping that psychological support would be well received.

Conclusions/Implications

Talking therapies and psychosocial interventions are acceptable sources of support. Person‐centred support which considers personal preferences and abilities can support people to live well with dementia.     

Stories of family caregivers of people with dementia in Greece: Implications for counselling

A substantial body of literature has identified high rates of burden, psychological morbidity, social isolation, health and financial difficulties among dementia caregivers. The present qualitative study adopted an Interpretive Phenomenological Analysis approach in order to explore the lived experiences of dementia family caregivers within the Greek sociocultural context. The sample was purposive and consisted of 10 women dementia family caregivers from Athens and Thessaloniki. Individual in-depth interviews were conducted and analysed according to IPA. The participants’ personal accounts included themes related to ethical/existential and cultural aspects of family caregiving; changes in family relationships; impact of the caregiving experiences; sources of support and help seeking; positive and meaningful aspects of the care experience. The research findings are discussed in the context of Gilligan’s moral psychological theory, and cultural dimensions of family caregivers. Implications for counselling interventions aiming at supporting caregivers are presented.     

Speech and non-speech processing in people with specific language impairment: a behavioural and electrophysiological study

McArthur and Bishop (2004) found that people with specific language impairment (SLI) up to 14 years of age have poor behavioural frequency discrimination (FD) thresholds for 25-ms pure tones, while people with SLI upto 20 years of age have abnormal auditory N1--P2--N2 event-related potential (ERP) responses to the same tones. In the present study, we extended these findings to more complex non-speech and speech sounds by comparing younger (around 13 years) and older (around 17 years) teenagers with SLI and controls for their behavioural FD thresholds and N1-P2 ERPs to 25 and 250-ms pure tones, vowels, and non-harmonic complex tones. We found that a subgroup of people with SLI had abnormal responses to tones and vowels at the level of behaviour and the brain, and that poor processing was associated with the spectral complexity of auditory stimuli rather than their phonetic significance. We suggest that both the age of listeners and the sensitivity of psychoacoustic tasks to age-related changes in auditory skills may be crucial factors in studies of sound processing in SLI.     

More than meets the eye: a consideration of the influence of a counsellor's visual impairment upon his therapeutic relationships

Other than through personal reflection and anecdotal evidence, I have had little opportunity to explore the influence of my visual impairment upon my therapeutic relationships. In order to address this, I conducted three research conversations with former clients (participants), each of whom had expressed an interest in participating in the research. Potential participants also had to meet the inclusion criteria for the research and provide informed consent prior to their participation. Research conversations were conducted between March and July 2009 and were analysed qualitatively, using a method informed by Moustakas's heuristic inquiry. Participants demonstrated idiosyncratic responses to my visual impairment; their perception of their responses to my visual impairment sometimes differed from mine. Feelings identified included uncertainty, disappointment and relief. My visual impairment appeared to influence the therapeutic relationship in a variety of ways, including resonance with the inner world significance of disability to the participant and interaction with my personal process. While not the therapeutic agent, my visual impairment had the potential to act as a catalyst in therapeutic change. The potential for me to either under-estimate or over-estimate the significance of my visual impairment highlights the need for continued self-awareness and the maintenance of an open and non-defensive attitude.     

The effectiveness of counselling with older people: Results of a systematic review

In 2003 the British Association for Counselling and Psychotherapy (BACP) commissioned a systematic review of the research evidence relating to counselling older people. This paper reports on some of the findings of this review, particularly those which address the effectiveness of counselling with this population. Electronic searches of the research literature spanned six databases and were supplemented by hand‐searches of reference lists and key journals, along with an extensive search of the “grey” literature. The location of papers testing interventions which fall within a definition of counselling set out by the BACP, with samples aged 50 years of age or above resulted in the inclusion of 47 relevant studies. Studies investigated a variety of mental health problems in older people, particularly depression, anxiety, dementia and the psychological impact of physical conditions such as chronic obstructive pulmonary disease. Of the 47 studies, eight tested counselling as a generic treatment, 15 tested cognitive behavioural therapy, 13 tested reminiscence therapy, and 11 tested various other specific approaches. The review concluded that counselling is efficacious with older people, particularly in the treatment of anxiety and depression and outcomes are consistent with those found in younger populations. Evidence as to the efficacy of counselling interventions in the treatment of dementia is weak.     

Introducing humanistic group counselling for somatisation in a primary care practice: Preliminary findings

Can group counselling help patients who present with symptoms that cannot be explained medically? Preliminary results of working with one such group are reported. Six patients in a primary care practice were offered weekly sessions for half a year. The findings suggest that the patients attended all group sessions. The patients reported experiences known to be related to group counselling, and when the group ended, patient reports show that the severity of their problems was reduced significantly (p<.001). Furthermore, during the six months after the group ended patients significantly (p<.025) reduced their visits to their general practitioners. These results seem to call for wider use of humanistic group counselling with somatising patients and further research into the impact of such form of counselling.     

Differential outcomes of skill training,group counseling,and individual cognitive therapy for persons with acquired visual impairment

As part of the Living Skills Training Program, group counseling and individual cognitive therapy were implemented to decrease psychological distress for adults with acquired visual impairment. This quasi‐experimental design study compared the outcomes of a 6‐month skill training program combined with a group counseling program (n = 37), with (n = 9) or without (n = 10) individual cognitive therapy, and with a control group (n = 42). The outcome measures were the Profile of Mood States and the Nottingham Adjustment Scale Japanese Version. The results showed that participants with low psychological distress decreased anxiety and increased acceptance of disability, even when they did not participate in group counseling. However, among the participants with high distress, they did not show any improvement without group counseling or individual therapy. The participants with high distress who engaged in group counseling showed an improving trend in attitudes toward others. Moreover, the participants who chose to engage in individual therapy in addition to group counseling showed decreased tension‐anxiety, depression, and fatigue, and significantly improved acceptance of disability. These results suggest that group counseling, combined with individual cognitive therapy, can be an effective part of rehabilitation treatment for clients who have high psychological distress.     

Reliability and validity of an auditing tool for person-centred psychotherapy and counselling for young people: The PCEPS-YP

The present study aimed to test the reliability and validity of the Person Centred and Experiential Psychotherapy Scale–Young Person version (PCEPS-YP). This is a newly developed and adapted 9-item scale which aims to measure counsellor competences in, and adherence to, person-centred practice, when working with adolescents. Counselling practice was assessed for 19 counsellors by randomly selecting 20-min audio segments from 142 recorded counselling sessions. Audio material was independently rated by eight raters using the PCEPS-YP to produce an average adherence rating per counsellor. Scale reliability was assessed via interrater reliability and internal consistency testing. Convergent validity was tested using ratings from the observer-rated Barrett-Leonard Relationship Inventory (BLRI Obs 40), and the scale was subjected to exploratory factor analysis. Results showed a high degree of internal consistency within raters (α = 0.95), marginally acceptable reliability across grouped raters (α = 0.58) and weaker reliability between pairs of raters (α = 0.50). Exploratory factor analysis revealed one strong factor for the scale with no subscales. Small-to-moderate correlations existed between the PCEPS-YP and the BLRI subscales and mean total score (rs = .12 to .40). Our findings suggest that the PCEPS-YP has potential as an effective, reliable and valid tool for assessing competence and adherence in person-centred practice with young people, both for research and for clinical purposes. However, training procedures need to be established that can enhance interrater reliability, and more evidence of convergent validity is needed.     

Career support needs of learners with historical disadvantage: an exploratory study

This study explored the career support needs of learners from a historically disadvantaged rural South African school setting. Participants were a convenience sample of 20 high school learners (females=60%; males=40%; age range 15–17 years; schools grades 9–10). They completed focus group interviews relating to their career awareness and needs. The data were thematically analysed. The results suggested learners have significant in-school career awareness and support needs. The learners accessed career related information informally from social networks they were using out of school rather than in the educational setting.