Community Counselling: Values and Practices

This article focuses on community counselling, specifically in African contexts. A community psychology approach is used as a framework for this discussion. This approach, linked to a critical perspective, highlights the importance of going beyond individualist assessments and interventions towards comprehensive approaches that locate the person in context, and that listen carefully to and engage openly with all voices in a way that highlights dynamics that oppress ourselves and others, for the purposes of building a supportive and health promoting environment for all. Perspectives and values relevant to this approach, and their implications for psychological practice, are discussed. In particular, the implications for psychological assessment and intervention are explored in some detail.     

Addressing Urgent Community Mental Health Needs in Rwanda: Culturally Sensitive Training Interventions

Rwandan leaders in the health and educational sectors have begun to discuss the necessity for establishing culturally appropriate community-based mental health counselling services in Rwanda, especially trauma counselling. The need for a community psychology approach is anchored in the lingering effects of the genocide and the continuing post-traumatic stress symptoms suffered by many in the population. Capacity building in an effort like this would require the design of multi-level counselling curricula that are sensitive to the social structures within Rwandan culture. These curricular endeavours call for the development of a National Counselling Centre to serve as a structural mechanism for organizing community-based counselling initiatives. We consider the community health services needs in Rwanda here, along with associated challenges and strategies for effective mental health services in a country with a recent history of genocide. A community psychology approach to mental health would benefit Rwandan society by making trauma counselling and recovery services available and accessible to citizens throughout the country.     

Gratitude,well-being and psychological distress among South African university students

This study investigated the associations between gratitude, measures of well-being, and indicators of psychological distress (depression and negative emotion) among South African university students. Data were collected from 198 first-year university students (female = 69.70%; mean age = 20.55 years, SD = 1.70 years) using measures of gratitude, flourishing, well-being, depression, and negative emotion. The results showed that gratitude is positively associated with measures of well-being, and inversely related to indicators of psychological distress. University-based support programmes should consider gratitude interventions to support student success.     

The good,the bad and the uncertainty: Trainees' perceptions of the personal development group

Background: Views about the purpose and role of personal development groups (PD group) in the counsellor training process are varied. Some argue they enhance self‐awareness, self‐exploration, the ability to be congruent and, ultimately, that they make for better practitioners. Others argue there is no clear evidence for such benefits and that they can actually be damaging to trainees. Aims: This study aimed to explore the beliefs of 25 trainees enrolled on counselling diploma or counselling psychology doctoral courses. It looked in particular at their perceptions of the purpose of PD groups and their expectations regarding support, difficulties and the scope of their participation. Method: Data was collected using open‐ended questions in an anonymous survey and was subjected to a thematic analysis. Results: Trainees appeared to hold mixed – and sometimes conflicting – views about the PD group. For some it was a positive endeavour that facilitated learning about self and clients, and helped in the processes of developing counselling skills and keeping the training group healthy. For others it was a feared space, which could elicit negative emotional experiences, and impact negatively on both learning outside of the PD group and the health of the group itself. Still others were unclear about its purpose. Hope/idealisation (of the process, the facilitator and course tutors) were also evident in the trainees' responses. Implications: Implications of these findings for counselling training are discussed.     

Extended problem solving treatment for depression

Introduction: Effective brief psychological approaches for depression that can be delivered by a variety of health professionals with minimal training increase access to treatment by patients. Problem Solving Treatment (PST) was developed for primary care and was modified for this study (EPST) to better meet the needs of mental health patients. Method: A total of 92 therapists from different professional backgrounds completed EPST workshops and treated 92 patients with major depression with interval clinical and treatment process assessments. Results: EPST achieved a significant reduction in depressive symptom scores, life problem scores, and there were few treatment non‐completers. Treatment outcome was predicted by process and therapist variables. Discussion: EPST is an effective and easy to teach treatment that can be delivered by a variety of practitioners and suitable for busy primary mental health care settings.     

Recording therapy sessions: What do clients and therapists really think?

Aims: Recording therapy sessions has become part of routine practice amongst trainee psychotherapists. To date most research has focused on the benefits of recording sessions to support clinical supervision. There are few data about the benefits or risks for clients. This study aimed to explore the views of clients who had had their therapy sessions recorded and therapists who had recorded sessions. Design: Five clients and 25 therapists completed a qualitative survey, the results of which were analysed using thematic analysis. Findings: All clients and several therapists reported that the recording devices are soon forgotten. Both therapists and clients reported the benefits of recording as being purely for the therapist with none identified for clients. Conclusions: It was observed that clients perhaps did not always understand how recordings were used, suggesting the need for clearer practice guidance.     

Therapeutic outcomes in the Welsh Government's school‐based counselling strategy: An evaluation

Aims: The purpose of this study was to evaluate the outcomes of school‐based counselling, as delivered in the Welsh Government's School‐based Counselling Strategy, for reducing psychological distress in young people aged 11–18. Method: The study used a quantitative cohort design, comparing levels of distress on either the Young Person's CORE (YP‐CORE) or the Strengths and Difficulties Questionnaire (SDQ) from baseline to endpoint. Data were available on 3613 episodes of counselling, across 42 datasets. Meta‐analytical procedures were used to identify the mean effect size and predictors of outcomes. Results: Within each dataset, counselling was associated with significant reductions in psychological distress, with a mean effect size (d) of 0.93(95% CI = 0.89–0.97) using a fixed effects model and 1.09 (95% CI = 0.97–1.22) using a random effects model. Datasets using the YP‐CORE had larger effect sizes than those using the SDQ, and datasets with more complete response rates had lower outcomes than those with poorer response rates. Conclusion: The results confirm that school‐based counselling, as delivered in the UK, is associated with significant reductions in psychological distress, comparable to adult counselling and psychotherapy services.     

Benchmarking key service quality indicators in UK Employee Assistance Programme Counselling: A CORE System data profile

Background: Levels of psychological distress appear to be increasing in the workplace, in parallel with the growth of employee assistance programme (EAP) provision offering a range of talking treatments. However, such growth takes place in the absence of a substantive body of supporting research evidence despite a quarter of a decade of research activity. Aims: To analyse a national sample of EAP data and profile relative service quality on a set of key service indicators. Method: CORE System data profiles of over 28,000 clients were voluntarily donated by six EAP service providers. An established benchmarking methodology was used to assess the relative quality of EAP service provision compared with published CORE System benchmarks for NHS primary care and UK higher education student counselling services. Results: High quality data profiled an EAP service clientele who were quantifiably distressed, accessed treatment quickly, with the majority completing treatment and demonstrating high rates of recovery and/or improvement relative to published benchmarks from the NHS and HE comparative sectors. Limitations of the study and implications for practice and further investigation are considered.     

The application of psychodynamic ideas to professional dance training

Concern about the welfare of professional dance students is growing as it becomes clearer that the training is not producing emotionally healthy and mature young people. Psychodynamic ideas and concepts offer a means of analysing the problems of the training and indicating where change needs to be implemented. This paper looks first at the areas of adolescent development towards separation, autonomy, the creation of peer relationships and the development of sexual identity and awareness, and shows how traditional dance training fails to facilitate their growth. The paper then discusses envy and competition and argues that they need to be addressed within dance training if they are not to be so destructive. The paper then suggests that group theory could enable the better use of the dance class. Finally, the idea of the body storyline is used to show that dance training has the capacity to have a creative and remedial effect on students, if training institutions provide a sufficiently facilitating environment.     

Tom Thumb in hospital: The fairy tale workshop in a paediatric oncology and haematology ward

Abstract

Definitions of and attitudes towards countertransference have changed throughout the twentieth century. From being seen as a contaminant in the analytical process, countertransference has come to be seen by many therapists as a potentially useful source of information about a client and his or her problems. There are dangers as well as benefits associated with analysis and utilization of countertransference. This article reviews these issues and proposes some guidelines that therapists may find useful when contemplating their countertransference reactions to clients, and when considering how best to utilize these.