Beliefs About Psychological Services (BAPS): development and psychometric properties

A scale to measure attitudes towards seeking psychological help was developed (Beliefs About Psychological Services [BAPS]) and evaluated. This scale was based on items gathered from students, colleagues, and the authors when asked about common positive and negative attitudes toward psychologists and their services. Items were also based on the Fischer and Turner (1970 Fischer, EH and Turner, JLeB. 1970. Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35: 79–90. [Crossref], [PubMed], [Web of Science ®] [Google Scholar]) Attitudes Toward Seeking Professional Psychological Services (ATSPPH) measure. Three studies are reported describing the construction and evaluation of the psychometric properties of the BAPS. The BAPS is an 18-item measure consisting of three subscales: Intent, Stigma Tolerance, and Expertness. Support was found for the reliability and validity of the measure.     

A qualitative exploration into how the use of prayer in counselling and psychotherapy might be ethically problematic

Aim: This research article contributes to the debate on the value and limitation of the use of spiritual strategies, like prayer, in counselling (Foskett & Lynch, 2001) by disseminating the insights that were gained from a qualitative study of mainstream counsellors whose work includes prayer. Method: Participants were 19 British Association for Counselling and Psychotherapy (BACP)‐accredited and Churches Ministerial Counselling Service (CMCS)‐approved counsellors who use prayer in their practice. They were interviewed, and the data were analysed using Interpretative Phenomenological Analysis. Results: The data reveal that counsellors who use prayer are aware that ethical problems may be encountered: if prayer changes the way that the counsellor is perceived; when using prayer with issues of psychopathology; if the counsellor uses prayer to impose faith on a client; when being professionally held to account; if prayer is used for avoidance or as a defence; if prayer is used to enhance the counsellor's power; if prayer is not part of the client's agenda; if prayer is used routinely; if prayer cannot be challenged; if there is a cultural pressure to pray; and if the prayer method is not matched to the client – but that their concern over potential ethical issues is not of sufficient strength to override their therapeutic use of prayer if facilitated with due care.     

The long‐term effects of counselling: The process and mechanisms that contribute to ongoing change from a user perspective

Aims: This qualitative study aimed to expand the limited evidence base about the long‐term effects of psychological therapies.Method: We conducted in‐depth interviews with 15 people, 1–3 years after primary care counselling, to investigate whether they could identify enduring benefits and the mechanisms that brought about and maintained them. From their narratives, we developed a model of the change process of counselling and mechanisms that were perceived as essential to produce lasting benefit. The model conceptualised movement through distinct phases: engagement; exploration of internal and external worlds; consolidation and negotiated ending. Results: Mechanisms integral to sustained impact were: the active engagement of people during and between sessions to work toward their own solutions; and acquisition through the change process of skills which could be further built on after the counselling ended. These enabled ongoing, dynamic change in the way people conducted their lives and relationships. Conclusion: A key concept in securing long‐term benefit was co‐production, both during counselling and in taking ownership of and using the ‘box of skills’ acquired. Support of the model was reinforced through comparison with the experience of three interviewees who reported no long‐term benefit.     

An evaluation of counselling and rehabilitation courses for Chronic Fatigue Syndrome

The aim of the current study was to evaluate the services offered by Action for ME to sufferers of Chronic Fatigue Syndrome using measures developed and validated in previous research. Preliminary studies had suggested that clients attending rehabilitation residential courses were benefiting from the service. A further, more in‐depth evaluation process with a greater number of health‐related outcome measures was warranted. In addition, assessment was widened to include other services offered to sufferers of the illness. Data relating to the usefulness and success of the services (rated by the clients) were also collected. Data from client volunteers were collected at baseline (that is, before intervention) and approximately six months later. Quantitative comparative analyses were conducted using within‐group comparisons to assess any improvements in scores at six‐month follow‐up from baseline. Fifty‐six participants completed wide‐ranging questionnaires assessing illness history, psychopathology, psychosocial factors and health and well‐being. Data relating to improvements in illness status and acceptability of treatment were also collected by means of global outcome measures. Both the counselling and residential groups showed improvements in many areas assessed at follow‐up. Most importantly, improvements were indicated in areas such as fatigue and the levels of disability suffered by patients. In addition, there were significant improvements in ratings of mood, anxiety, depression and physical symptoms. Overall, clients reported satisfaction with the care received and most found the services useful. All of the participants who completed the evaluation stated that they would recommend Action for ME services to fellow sufferers. The outcome of the current study is encouraging. The data presented provides evidence of the high level of support and advice Action for ME offers to sufferers of this illness. Furthermore, measurable improvements in scores relating to illness status were accompanied by improvements in mental health and psychosocial variables in the patient group.     

Discourse analysis: Rich pickings for counsellors and therapists

Aim: It is only relatively recently that discourse analysis has begun to rise to prominence in the fields of counselling and psychotherapy. This paper briefly explains ways of understanding discourse analysis, discussing what the approach can offer counselling research and practice. Approach: An initial categorisation of recent discourse analysis studies is offered, to demonstrate diverse ways in which this type of research can address issues relevant to counselling practice. The five categories proposed range from the examination of language use in therapy to analyses that focus on the social structures, meanings and power relations related to therapy. Implications: The paper demonstrates that through the critical analysis of counselling sessions, research interviews, written texts and other materials, discourse analysis can provide insight into ways in which counselling operates as a social practice, and so help counsellors to contextualise their work within broader social structures and processes.     

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 effectiveness of workplace counselling: A systematic review

Background: In response to the stresses of the contemporary workplace, the challenges of maintaining satisfactory work-life balance, and the costs to business of employee mental health problems, many organisations have contracted to make counselling services available to their staff. It is essential to evaluate the effectiveness of workplace counselling, in order to maintain standards, and to identify examples of good practice. Objectives: This paper presents a comprehensive, systematic review of the effectiveness of workplace counselling. Findings are analysed in terms of client satisfaction, psychological functioning, the meaning of work, work behaviour, and negative outcomes. Findings: Taken as a whole, the results of research suggest that counselling is generally effective in alleviating psychological problems, has a significant impact on sickness absence, and has a moderate effect on attitudes to work. Discussion: Methodological issues are discussed, and it is recommended that more high-quality research is required in order to reinforce the evidence base for workplace counselling in relation to a number of key questions.     

Expectations of Counselling: A Comparison Between Evangelical Christians and Non-Evangelical Christians

A sample of 211 adults returned a questionnaire that was a modified version of Tinsley's (1982) Expectations about Counselling: Brief Form. The sample was recruited from an evangelical Anglican Church, an evangelical Anglican theological college, a doctor's surgery and a number of educational establishments. Analysis of the data compared subjects' choice of counselor between evangelical Christians and non-evangelical Christians. Results indicate that evangelical Christians do not have significantly lower expectations about counseling, in comparison with non-evangelical Christians, except in the Directiveness and Attractiveness sections. There was, though, a significantly higher expectation of the counselor with regard to Religious Behavior by evangelical Christians in contrast to non-evangelical Christians.     

The discourse of being ‘triggered’: Uses and meanings among counselling students

Despite the initial understanding of the word ‘triggered’ as relating to the clinical phenomenon of post-traumatic stress disorder (PTSD), this language has become a common part of the vernacular today, used by many people to apply to a wide variety of experiences and events. Counselling students are particularly sensitised to trauma, as well as identity politics, and are familiar with trigger warnings at college. They themselves have experienced trauma at high rates. Therefore, we were interested to understand how they might be using the word and interpreting the experience of being ‘triggered’, whether different sources of being triggered are related to emotional reactions, and whether a discourse analysis might indicate how and why the term has become useful and for what other experiences it might be serving as a stand-in. In this mixed-methods study, 79 counselling students from around the country shared their definitions and experiences of being ‘triggered’. Participants completed surveys and wrote narratives, which, via thematic qualitative analysis, were coded into five themes. The quantitative analysis focused on the relationship of feelings to themes and the relationship between anger suppression and coping with each theme. Discourse analysis explored how individuals wrote about responsibility and anger. It was discovered that those who wrote about being triggered from a past sexual assault did not discuss anger, nor the responsibility of others to protect them (as those who wrote about microaggressions did), but positioned themselves as overreactors. Results are discussed with regard to training and practice.     

Addressing social determinants of mental health in therapy: A thematic synthesis

Background

The importance of addressing social determinants of mental health in therapy is well-documented. However, there appears to be limited research on what this actually involves in practice and how best to prepare therapists to work with individuals experiencing adverse social determinants.

Aims

The aim of this review was to draw implications for practice and training from reviewing research on addressing social determinants of mental health in therapy.

Methodology

A qualitative systematic review of the research on addressing social determinants of mental health in therapy was conducted, extracting papers from eight databases: Cochrane Library, ASSIA, CINAHL Plus, PsycInfo, Psychoanalytic Electronic Publishing, Science Direct, Scopus and Web of Science. Out of 127 papers found, five met the eligibility criteria and were quality-assessed and analysed thematically.

Findings

The thematic synthesis generated three main themes: “the therapeutic relationship,” “adapting to client context” and “community as a resource,” with eight subthemes.

Conclusion

This thematic synthesis highlights the importance of the therapeutic relationship and adapting mental health support to client frame of reference and context to address social determinants of mental health in therapy. It emphasises community as a helpful resource for informing training and therapeutic interventions, as well as a significant resource for people experiencing adverse social determinants.