Applied pluralism in the evaluation of employee counselling

The method and major findings of a complex, 'pluralist' evaluation, which investigated the effectiveness of the counselling provision of an employee support and counselling service in a local authority education department over 22 months, are outlined. Reference is made to the underlying philosophical approach of integrated pluralist evaluation, which may represent a significant step forward from the accepted methods of triangulation. In addition to achieving predicted high satisfaction rates from clients, counsellors and clients both indicated significant improvements in all measures used. These were maintained at follow-up which took place at intervals from 1 to 18 months after counselling had ended. Reduction in absenteeism post-counselling suggested the possibility of very substantial revenue savings. Responses also indicated the acute, and often chronic, need for employee counselling provision in the education system.     

An appraisal of abortion counselling

Abortion counselling is examined on the basis of 306 cases seen in a pregnancy advisory service. Its aims and process are compared with other forms of counselling; problems of ambivalence, pressure from others, economic reasons and patient fears are discussed. Because of the many clients who presented with these problems and with relationship difficulties, it is suggested that a more broadly-based 'watershed counselling' service be established. Such counselling could provide full information about abortion and its alternative, and could also provide useful aftercare.     

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.     

Personal responsibility,empowerment and medical utilization: a theoretical framework for considering counselling and offset costs

The problem of effectively managing patients with functional somatic symptoms remains huge in both primary and hospital care, although the potential benefits of mental health interventions such as counselling or psychotherapy are still not widely accepted. Unfortunately, the cost-effective evaluation of counselling has been beset by methodological problems, which stem from attempting to make comparisons between counsellors with different types of training, therapeutic approach and case mix. Since these real-world variations in counselling practice are likely to remain, it is proposed that a different approach to the evaluation of cost-effectiveness should be adopted in the hope of accelerating acceptance of the value of psychological interventions for the army of patients who are currently labelled as ‘difficult’ or ‘heartsink’ and who do not receive the treatment they deserve from the health-care services. It is proposed that, since the common aim of almost all mental health interventions is to engender or enhance a sense of ‘personal responsibility’ in patients/clients, this core objective should form an agreed ‘yardstick’ against which to evaluate the impact of various mental health interventions. Furthermore, since personal responsibility and future health-care utilization (and associated costs) can be assumed to be directly causally related, it is proposed that offset costs should form the basis for future cost-effectiveness evaluations.     

The preparation of counsellors in Europe: Possible solutions for an impossible task?

The growth of counselling and psychotherapy presents trainers in Europe with significant opportunities. But these need to take account of human development over the millenia, harnessing ancient psychology to the resolution of contemporary problems. In particular, there is a need for contextual counselling, beating practice in culture. Extrapolating from UK data, a minimum practitioner requirement for Europe could be 50,000-75,000 counsellors. With only minimal training programmes in many European countries, meeting the seven core criteria of training seems impossible. One possible solution is to cluster people with limited training around a high-standard professional counsellor—a system used in the UK for situation-specific counselling. A number of European states are now seeking to develop a counselling capability. Training for this should break new ground by learning from older systems but also being unafraid to adopt novel solutions.     

Counselling at a distance: Challenges and new initiatives

Traditional views of the possibilities of counselling at a distance, mediated by telecommunications technology, are challenged. The current status of telephone counselling is reviewed- it is proposed that the telephone is a vibrant innovative medium for therapeutic work. Computer involvement in therapeutic work is defined, and the issues confronting computer-mediated therapy are contrasted with developments in computer-supported co-operative work. It is concluded that active collaboration between therapists, social scientists and computer scientists is required to develop therapy-specific computer applications to mediate in therapy-at-a-distance.     

Ethical Issues in Counselling at Work

Providing counselling in the workplace can challenge the ethical principles on which counselling is based. A series of questions is identified designed to focus attention on aims, outcomes, referrals, confidentiality and resources. It is concluded that confronting ethical dilemmas is a continuous responsibility for counsellors. Frequently issues are managed rather than resolved. However, in confronting and managing these issues, the values underpinning organisational life can be challenged and, perhaps, changed.     

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.     

Beratung in Abgrenzung zur Psychotherapie

There are many forms of verbal interaction between people as distinguished from professional interactions, such as patient guidance, counselling and specialized psychotherapy. Psychotherapy is the treatment of patients and illnesses which includes a special responsibility of the therapist for the well-being of the patient. Psychotherapists have to be specially licensed while counselling can be done by any person who has expert knowledge. The counsellor is only responsible for the correctness of the information provided, while the client is responsible for any consequences. There are also professional rules for good counselling in respect to the form of interaction, the clarification of goals, the method of providing information, strategy planning, clarification of options for action, support for decision making and necessary documentation. Counsellors have to be aware of possible problems, such as misunderstandings and aggravation of problems.     

The responsibilities of counsellor supervisors: A qualitative study

A study was carried out to investigate whether supervisors of counsellors considered themselves to be clinically responsible for the work of their supervisees, what responsibilities they considered themselves to have for the counsellors' work, and how they managed their responsibilities. The purpose of the study was to enhance the counselling profession's understanding of the responsibility of supervisors and of the supervisory relationship. The study was confined to supervisors working in private practice. Ten experts in the field of counselling and supervision were interviewed, using a semi-structured questionnaire. The interviews were analysed using the 'constant comparative method'. They revealed that the participants would not use the term 'clinical responsibility' to describe their responsibilities. There were mixed views about the nature of the responsibility of the supervisor when supervising counsellors practising independently. The participants indicated a preference to supervise only the most experienced counsellors, with whose practice they were already familiar and in whose work they already had considerable confidence. None of the supervisors interviewed considered themselves to be legally responsible for the counsellors' work. All the participants were aware that the risks associated with counselling in private practice could be considerable and had an acute sense of responsibility for the content of the work. Reluctance to take action against supervisees who were in breach of the code of ethics was expressed. There was scepticism about the requirement for them to have supervision for their supervisory work. Implications for the practice of counselling supervision and for the profession are discussed.     

Intimacy and computer communication

The relationship between intimacy and communication which uses computer technology is addressed. Definitions of intimacy are considered, and the nature of intimate conversations which use computers as a communications medium are discussed. Implications for counselling are examined.     

HIV counselling in the 1990s and beyond

It is 15 years since AIDS was first described in the medical literature. Reports of immune system disorders among gay men in large cities in the USA in 1981 signalled the start of what has now become a pandemic affecting millions of people. The psychological impact of HIV infection has been well-documented and it is widely reported that psychological treatment is mosdy provided for the treatment of adjustment reactions. Counselling for HIV prevention and HIV antibody testing has also been at the forefront of psychological support services. More recenuy, there has been a determined effort among counsellors to develop a range of psychotherapeutic approaches to help people to cope with and adjust to living with terminal illness. Most research published in the 1980s on the psychological impact of HIV addressed the infected individual. This symposium introduces a growing interest in the field for counselling those who are affected by HIV, including families, health-care workers and communities. This trend is becoming the focus of many counselling programmes worldwide and is likely to continue throughout the 1990s and beyond.     

The ethical practice of Web C ounseling

The emergence of on-line counselling services for addressing problems ranging from poor self-esteem, stressful relationships and addictions raises serious ethical concerns in this new electronic venue. A number of ethical considerations are discussed. The evolution of the National Board of Certified Counselors' Standards for the Ethical Practice of WebCounseling is described.     

The impact of Christian counselling on survivors of sexual abuse

The absence of research and growing involvement of Christians in all areas of counselling gave rise to this study which explores the impact of Christian counselling on adult survivors of sexual abuse. The sample of 44 women and 5 men from an inter-denominational, self-help network, completed a self-report questionnaire of perceived Christian and professional counselling experiences involving issues of trust, power, directive approach, use of prayer and Scripture, responsibility and outcome. Results show that Christian counselling is experienced as qualitatively different from professional counselling: Christian counsellors are perceived as significantly more directive and more powerful than professional counsellors and the overall outcome was perceived more negatively. A number of key factors were identified which influenced the negative experience of some Christian counselling. These included having experience of professional counselling, an emphasis on the use of prayer and Scripture, perceiving the counsellor to have different goals from the client, feeling blamed for continued distress and having prior experience of prayer ministry. Implications for counselling practice and training are discussed.     

The 'new career' changes: Understanding and managing anxiety

Extensive changes in work structure and conditions have been widely noted, and many more are predicted. The impact on individuals of these changes is examined. This generally involves the expectation of diminished job/work security, and a requirement for individuals to demonstrate greater responsibility and autonomy in the workplace. The importance and meaning of work to individuals is explored from a psychoanalytic perspective. Particular attention is given to ways in which the predicted changes may create anxiety, when there is a threat to such a significant aspect of human activity. It is suggested that those involved in the counselling process in the workplace or in career guidance may need special awareness of these issues, and the ways that they may manifest in the workplace. The concept of 'containment' is examined as a helpful notion in considering intervention approaches     

Experimental manipulations of responsibility: An analogue test for models of Obsessive-Compulsive Disorder

Several authors attribute excessive responsibility a predominant role in Obsessive-Compulsive Disorder (OCD) [Salkovskis, P. M. (1985) Behaviour Research and Therapy, 23, 571–583; Rachman, S. (1993) Behaviour Research and Therapy, 31, 149–154; van Oppen, P. & Arntz, A. (1994) Behaviour Research and Therapy, 32, 79–87]. The present studies aimed at demonstrating the link between different levels of perceived responsibility and checking behaviors by experimentally manipulating responsibility in non-clinical Ss. In the first study, a sound recognition task was used to compare checking behaviors in Ss with high (HR) and low (LR) perceived responsibility. Only one variable was significantly different, Ss from the HR group reporting more anxiety during the task than Ss from the LR group. Results did not support a link between responsibility and checking behavior. In a second study HR and LR Ss were compared on a manual classification task. Subjects from the HR group hesitated and checked more, and reported more preoccupation with errors and anxiety during the task than Ss from the LR group. Since perceived severity of the outcome was the most variable affected by the manipulation, the implications for current models of OCD are discussed and an alternative explanation is attempted. Finally, clinical implications are examined and suggestions are made for future directions of research.     

The challenge of prejudice: counsellors’ talk about challenging clients’ prejudices

This paper considers the implications for training and practice of counsellors’ responses to the notion of challenging clients’ prejudices. It explores tensions in counselling discourse between social responsibility, responsibility to the client and responsibility for one's self as counsellor. Three focus groups of counsellors were asked whether a counsellor should challenge clients’ prejudices. Responses were categorised as challenge, not-challenge or exit responses. Discursive themes identified in the responses are: managing congruence and being non-judgemental; self-care and self-respect; and social responsibility. Strategies for managing the discursive conflicts identified in responding to counsellor-identified client prejudices are summarised.     

The role of the regular teacher in a whole school approach to guidance counselling in Ireland

A whole school approach to guidance counselling has been promulgated by Irish policy-makers as a model of good practice in the delivery of guidance counselling in the post-primary sector since the 1998 Education Act (DES, 2005a, 2009, 2012). This approach to guidance counselling provision is viewed as a whole school responsibility where schools are expected to collaboratively develop a school guidance plan to support the needs of their students. The role of the regular teacher in a whole school approach to guidance counselling has received very little attention either in the Irish education system or in empirical research. This article will address this deficit through its discussion of a case study carried out in one school in 2012. It will position the findings from the study in the context of the re-allocation of post-primary guidance counselling provision in the national Budget 2012 that has witnessed the substantive erosion of the guidance counselling service in the last two years.     

The impact of the socio-economic crisis on intrapsychic and intersubjective processes within the therapeutic relationship: Implications for the ethical practice of counselling psychology and psychotherapy

Using attachment and mentalisation theories as a framework, the present paper aims to explore the impact of the current socio-economic crisis on the micro-processes and interpersonal dynamics that emerge between client and therapist as well as the ethical dilemmas that surface within the context of the therapeutic relationship. The first part of the paper focuses on the intrapsychic level and the subjective appraisal and experience of the crisis, as this may differ from individual to individual as well as the unique meaning-making processes that take place for clients and therapists alike. It is argued that the socio-economic crisis itself cannot be seen as an entity that is entirely independent and external to the individual but as a phenomenon that interacts in unique ways with the individual’s inner current and past experience. The second part focuses on the exploration of intersubjective processes that emerge between client and therapist, in particular the transference-countertransference dynamic, as this develops within conditions of increased arousal and anxiety. The role and responsibility of counselling psychologists in preserving reflexivity, empathy and a mentalising stance (through supervision and personal therapy) are highlighted in order to safeguard the ethical and competent practice of counselling psychology.     

Gambling counselling in Australia: focus on cognitive counselling techniques

A number of specialised counselling services are now available to assist individuals who experience difficulties as a result of problem gambling behaviour. Clinicians within these services may utilise one or a number of counselling approaches depending on their own preferences and their assessment of the counselling style suitable for use with particular clients. The purpose of this paper is twofold. The first is to describe the range of specialised gambling counselling services now available in Australia. The second aim is to provide clinicians in the field with a range of practical cognitive counselling strategies that may be used to good effect to assist clients to reassess their attitudes towards and thoughts about gambling.