Social and political perspectives on the psychotherapy and counselling profession: Returning caravelles

The counselling and psychotherapy profession is changing. For the first time in its history, it has begun to receive substantial Government funding in the UK and it also has to contend with the principles of evidence-based practice and the policies of the New Public Management systems in many countries. This paper argues that such recent developments present challenges to the profession’s historical apolitical standpoint. More importantly, it argues that the present social and political climate offers many opportunities such as the possibility of learning from psychosocial practices in other countries. The paper will look, in particular, at what can be learned from Latin America and India where mental health care and psychological therapy have adopted grassroots involvement, health-focused approaches and innovatory therapeutic methods.     

Transformational education for psychotherapy and counselling: a relational dynamic approach

ABSTRACT

An evolving relational dynamic approach to psychotherapy and counselling education is described. Key themes integrated within the approach are the learning community and transformational relationships. Learning is a reciprocal change process involving students, teachers, supervisors and therapists in overlapping learning communities. Drawing on evidence that effective outcomes in therapy correlate with effective aspects of the therapeutic relationship, the relational dynamic approach emphasises the findings of attachment and intersubjectivity theorists. The intersubjective matrix of infant/caregiver and client/therapist is mirrored and embodied in the relational ethos of training and actively engaged in group supervision. An emphasis on embodied relating is discussed, drawing on infancy studies and recent neuroscientific findings     

Humour as a tool in counselling and psychotherapy: A reversal-theory perspective

Humour has occasionally been regarded as a valuable tool in counselling and psychotherapy. The specific uses of humour and its potential as a coping tactic are rarely described. The therapeutic use of humour is accordingly examined in the light of reversal theory (Apter, 1982a). It is suggested that the use of humour needs to be related to the motivational task implicit in the therapeutic interaction.     

An integrative review of the person-centred and experiential therapy literature on delivering individual video counselling and psychotherapy

Based on an integrative review of the relevant literature in and on person-centred and experiential (PCE) therapy, this study identifies and discusses the findings of 13 articles on the delivery of individual video counselling and psychotherapy. Six overarching themes were identified: the discrepancy of the experiences of clients and practitioners; the possibility of good-quality PCE therapy (psychotherapy and/or counselling); “doing” PCE therapy online; “being” online; the role of technology; and implications for training and practice. It is suggested that all these have implications for ongoing practice and education/training, and need to be considered by practitioners, educators/trainers, and professional bodies.     

The place of self psychology in group psychotherapy: a status report.

This article reviews the growing contribution of self psychology to group psychotherapy. The basic self-psychological concepts as they are applied to group dynamics and the treatment process are explored. Transference, countertransference, and self-restitutive patterns are illustrated in a clinical vignette that includes a "difficult" patient's impact upon the interactional and group-as-a-whole processes. Several directions for future investigation are described.     

Using the sixth sense: The place and relevance of language in counselling

Counsellors' primary skills, apart from listening to clients' words, lie in responding with well-chosen words. Ideal counsellors say just the right thing, at just the right time, in just the right way. It is suggested that emphasising how words relate to cognitive, emotional and relationship events can take counselling on to new ground. In addition to felt experience being in sight, sound, feeling, smell and taste, language itself is posited as a 'sense' through which we perceive, and are joined to, our environment. From the starting point that counsellors use words to heal, attention is paid to how wrong words injure clients, how words are a major component in making relationships, and how they create and define felt experiences. 'Metaphorical schemas' are posited as bases for shaping felt experience. These schemas are a theory of subjectively felt emotion and cognitive understanding.     

Relational measures in psychotherapy research on process and outcome: a commentary on the studies

Using Benjamin's (2000) Structural Analysis of Social Behavior, we evaluated change in "self-directed" affiliation and autonomy and prediction of treatment response and relapse/recurrence among adult outpatients with recurrent major depressive disorder consenting to acute phase cognitive therapy (A-CT; Beck, Rush, Shaw, & Emery, 1979; N=156); A-CT responders randomized (N=84) to 8 months of continuation phase cognitive therapy (C-CT; Jarrett, 1989; Jarrett et al., 1998; Jarrett & Kraft, 1997) or assessment-only control; and C-CT and control patients entering a 16-month, assessment-only follow-up (N=74). Self-directed affiliation and autonomy increased after A-CT, and C-CT further increased affiliation and autonomy. Affiliation and autonomy did not predict A-CT response, but lower affiliation and higher autonomy pre-A-CT predicted relapse/recurrence post-A-CT. We discuss potential clinical implications of these results and present case examples to illustrate patterns of change.     

National Attachment and Patriotism in a European Nation: A British Study

This study explores identification with one's national group using two distinct but interrelated concepts: identity content and relational orientation. Theoretical distinctions were drawn between two forms of identity content: traditional-cultural and civic, and between two forms of relational orientation: blind and constructive. The multidimensionality of both identity content and relational orientation and the relationships amongst these components were examined in a British sample: positive relationships were hypothesized between blind orientation and traditional-cultural content and between constructive orientation and civic content. Principal components analyses confirmed the hypothesized factor structures, and the resulting scales were highly reliable. Relationships amongst the resulting factors were explored using regression analyses. The overall results indicate support for the orthogonality of both the two orientation dimensions and the two content dimensions. Moreover, the hypothesized relationships between forms of orientation and content were largely supported. In conclusion, this study highlights the importance of looking at the relationship between identity content and relational orientation. The implications of these observations for theory and research are discussed with reference to using categories to "group" participants in research, citizenship education, and more general attitudes towards social change.     

On the margins: a psychoanalytic perspective on the location of counselling, psychotherapy and counselling psychology training programmes within universities

Despite the continuing expansion of psychotherapeutic training programmes within universities in the UK, very little has been written about the psychological strains which may be experienced by teams working within the context of higher education. This theoretical paper offers a psychoanalytic perspective on the location of such teams, drawing on Kleinian conceptualisations of anxiety and projective identification, as well as Menzies-Lyth's concept of social defence systems. The paper explores the way in which psychotherapeutic teams in general and counselling psychology teams in particular may be at risk of becoming the locus of unconsciously split-off emotional aspects of the institution. The role of such teaching teams within universities is discussed and brief suggestions for future practice outlined.     

A commentary on the symposium: The use of history in the social sciences curriculum

The use of history in the social science curriculum leads to a deepened understanding of the respective disciplines of anthropology, education, sociology, political science, psychology, and history of science. The use of history in the social sciences also leads to extradisciplinary interests in history, philosophy, and literature. Some highlights from a symposium and from the recent literature are discussed.     

Facilitating the client's experience of relational depth in counselling and psychotherapy: A thematic review

Aim

There is increasing interest in relational depth and its relevance and benefits for clients receiving therapy in a number of different therapeutic orientations. This research set out to draw together the available evidence from a wide range of therapies about clients' experiences of relational depth. The aim was to identify approaches that create the conditions where relational depth is more likely to be facilitated. The research focused on clients' views, given the increasing emphasis on their experiences in therapy.

Methodology

A systematic search of papers published in English between January 1996 and September 2022 was conducted using EBSCO Host, Google Scholar and citation chaining. Twenty-seven papers met the inclusion criteria, and a thematic analysis was conducted on these papers.

Findings

Six themes were identified: (1) establishing dialogue with the client's inner world, (2) working with attachment in therapy, (3) responding sensitively to the client's beliefs and values, (4) deepening the client's understanding of the therapist, (5) addressing ruptures in therapy and (6) the client's role in meeting at relational depth.

Conclusion

Facilitating the client's experience of relational depth can support and enhance many aspects of therapeutic practice and in itself may contribute to healing. Therapists who offer warmth and genuine engagement are more able to build confidence and trust, as long as these conditions are received by their clients. It is the clients who ultimately decide whether or not to share their deepest feelings.     

Creating a research agenda in career counselling: the place of action theory

After identifying historical and current problems in career counselling research, we propose a research agenda based on contextual action theory. This theory has been used as a framework for research in the career field and for general counselling practice. It is advantageous for several reasons including its conceptual basis, its detailed qualitative and quantitative research method, and the significant link it provides between research and practice. It is supported by the action-project method, an integrated set of procedures developed for conducting research. Contextual action theory and the action-project method can address major emerging issues in career counselling, for example the place of emotion and the use of narrative, and advance the research agenda in this field.     

Choice and dissonance in a European cultural context: The case of Western and Eastern Europeans

Prior research demonstrates that members of collectivistic cultures are less likely to reduce cognitive dissonance after making a choice, compared to members of individualistic cultures. This difference has been attributed to different conceptualizations of choice that derive from different self‐construals across cultures. In individualistic cultures, choice leads to stronger commitment to the chosen option compared to collectivistic cultures, because it implicates core aspects of the independent self, such as personal preferences. However, this cultural variation in postchoice dissonance has thus far been studied exclusively by comparing East Asians and North Americans. Building on the assumption that this difference is due to different construals of the self, we conducted an experiment with movie choices using the classic free‐choice paradigm to examine differences in dissonance reduction between Western and Eastern Europeans, two populations known to differ with respect to interdependence. The results show that Eastern Europeans are less likely than Western Europeans to reduce postchoice dissonance by spreading their alternatives. Our findings speak to the generalizability of the hypothesis that in cultures differing in independence or interdependence people also differ in the way they construe choice, as well as in the way the act of choosing affects their self‐concept.     

The nature space. A reflexive thematic analysis of therapists' experiences of 1:1 nature-based counselling and psychotherapy with children and young people: Exploring perspectives on the influence of nature within the therapeutic process

Nature-based therapy is an emerging and rapidly developing field within counselling and psychotherapy, yet there is little published empirical research, or integrated models relating to its practice with Children and Young People (CYP). The present study aimed to explore therapists’ experiences of one-to-one nature-based counselling and psychotherapy with CYP, eliciting perspectives on the interaction between nature and the therapeutic process. A reflexive thematic analysis provides preliminary insights into possible mechanisms of action with the potential to inform a longer-term exploration of whether nature-based therapy is effective, for whom and why. The study highlights the need to better explore and understand how nature-based therapy supports relational and intrapsychic change in interaction with developmental processes, to inform construction of coherent and consolidated theory and models for practice.     

The participation of children and adolescents in family counselling: The German experience

This paper reflects the experiences of young people in child guidance and family counselling. For this purpose, first the institutional background of these counselling services in Germany is outlined. The fact that the adolescents concerned feel partly excluded and insufficiently integrated into the counselling process is illustrated through qualitative analysis of the experiences 17 young people had during their counselling process. These empirical findings are critically discussed in terms of the institutional conditions and methodical approaches which counteract the involvement of the actual addressees of the counselling service. The paper concludes that professionals need to attend more to facilitating the participation of young people.     

A journey through languages: A systematic literature review on the multilingual experience in counselling and psychotherapy with children and adolescents

The purpose of this research was to address the gap in the existing literature on the multilingual aspect of language in psychotherapy with children and adolescents. This research aimed at interpreting possible meanings for clients of being multilingual in the therapeutic process as well as reflect on the influence of clients’ multilingualism in the therapeutic relationship. The researcher used a systematic literature review (PRISMA guidelines, 2009) to select articles based on empirical qualitative/mixed studies with participants up to 25 years old or adults referring to childhood/adolescence. The researcher used thematic synthesis (Thomas & Harden, 2008) to extract, analyse and interpret data. The rigour of this study was enhanced by the use of auto-ethnography as a source of evidence (McLeod, 2015). The auto-etnography documents self-reflections on personal experience of being multilingual contributing to deeper contextualised knowledge. The findings confirm previous research on the existence of a link between multilingualism and “identity” (Costa, 2020, p. 5). This research suggests that the meaning a client gives to bilingualism can be co-constructed within an attuned therapeutic relationship. In this co-construction journey, there is a significant opportunity for children and young people in finding their way through languages, hence reaching emancipation and affirmation in the world. The main limitation of this research relates to the fact that there are not many studies with children/young people. This led the researcher to also include studies based on a mixed sample and with adults referring to childhood/adolescence, which might have influenced the interpretation of findings.