Qualities of reflection: using Saul’s (2001) On Equilibrium to restore humanity to reflection in healthcare

Reflection features strongly in health and care work as a tool for personal and professional development and can support us as practitioners to be critical and self-aware in practice, of practice and the impact on clients and patients. Its power to transform learning and practice, however, has been watered down through recipe-following in reflective recording and through the avoidance of recording uncertainty or practice that might not measure against professional codes. Drawing on the humanist philosophy of John Ralston Saul, I suggest using Saul’s ‘six qualities’ as themes for reflective questions. I reflect on the influence of reason through codes of practice and offer suggestions for questions to restore an awareness of Self in work with clients and patients. Finally, from my experience as a counselling student and healthcare educator, I argue that we should have a greater appreciation of the power of uncertainty in reflective recording.     

Action: a bridge between vocational and mental health counselling*

A theory of goal-directed action is proposed as a conceptual link between vocational and mental health counselling. Originally emerging from the vocational counselling field, contextual action theory is presented as a critical conceptual link not only between mental health and occupational life but also between counselling practices in these domains. This specific application of goal-directed action to vocational and mental health counselling is addressed by describing counselling as goal-directed action, the five tasks of counselling it invites, and tools for supporting client goals, such as the self-confrontation interview.     

The ‘tyranny of time’: getting to the heart of the impact of educational cuts on the provision of guidance counselling in Ireland

The Irish Education Act (Government of Ireland 1998) stipulates that each young person in secondary school in Ireland is entitled to access ‘appropriate’ guidance. It has been argued that this very right has been eroded since Budget 2012, where resource re-allocations in guidance counselling are obstructing the requirement for schools to implement this section of the Act. This qualitative study explored the effects of ‘educational cutbacks’ from the perspective of guidance counsellors. Findings from interviews with guidance counsellors, suggest that the effects of such cutbacks in guidance counselling are far-reaching and ultimately students are the one’s losing out. The paper proposes that there is a need to reinstate guidance counselling hours to allow guidance counsellors provide a comprehensive service to young people – which they are entitled to.     

On being guided – a typology of career guidance in EU discourses*

With this article we want to illustrate how the central publications of the European Union legitimate a role of Career Guidance Services (CGS) that help in establishing a desired form of social order. Using the Sociology of Knowledge Approach to Discourse, we reconstructed four typical metaphorical conceptualisations of CGS that go along with desirable and taken-for-granted subject positions. The results reveal the assigned active role of CGS in establishing a specific vision of and in transforming the European society. We conclude by outlining the ways in which critique is expressed within the discourse and by highlighting the inherent ambivalences of these practices of critique.     

Clinical and demographic features of the online counselling client population

The purpose of this research was to determine the demographics and characteristics of clients seeking online counselling over an eight‐month period of clinical online practice. Two hundred and seventeen clients seeking Internet counselling completed a Counselling Application and a Life History Questionnaire. The characteristics of the relatively new client population include the following categories: gender, age groups, martial status, education, primary reason for seeking online therapy, secondary issues, frequency of email exchanges, and online vs. face‐to‐face counselling preferences. Implications for online counselling practice are discussed.     

An outcome evaluation study of a psycho‐educational course in a primary care setting

Rationale: To date relatively little research has examined the effectiveness of psycho‐educational courses provided in a primary care setting to adults with mild‐to‐moderate mental health concerns. Aims: To determine whether group psycho‐education could be a viable alternative to individual counselling by (1) assessing the clinical effectiveness of an 8‐week psycho‐educational course, and (2) examining the group outcomes in comparison with individual treatment outcomes from a previous study in the same counselling service. Method: A total of 57 participants attending a psycho‐educational course provided data over a 36‐month period, using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) pre‐ and post‐intervention. A comparison was then made with the data of 58 previous participants of individual counselling evaluation, using the same CORE‐OM system. Results: Participants reported significantly lower levels of psychological distress after attending the course and these results are comparable to outcomes measured in the same service for individual counselling, indicating that group interventions could be considered a legitimate alternative to individual counselling, thus increasing cost effectiveness and reducing waiting times. Limitations of the study and implications for practice and further investigation are considered.     

Thought recognition and psychological well‐being: An empirical test of principle based correctional counselling

Aims: To determine the relationship between thought recognition, a major construct of principle‐based correctional counselling, and psychological wellbeing. Method: Following several weekly group sessions of Principle‐Based Correctional Counselling, 54 adult prisoners on probation completed two measures of thought recognition and the Well‐Being Inventory. In a follow‐up study, 30 participants completed the Mindful Attention Awareness Scale. Results: Significant positive relationships were found between both measures of thought recognition and psychological wellbeing and, in the follow‐up study, both measures of thought recognition and mindfulness. Discussion: Possible explanations for the relationship between thought recognition and psychological wellbeing, and thought recognition and mindfulness are discussed. Implications for practice: Teaching correctional clients the principles behind generic human psychological functioning, and the innate design behind human thinking, appears to improve their thinking and draw out their innate healthy functioning.     

The relationship between basic need satisfaction and emotional eating in obesity

Emotional eating has been identified as a factor that promotes the development and maintenance of obesity and hinders its treatment. This study investigated the relationship between unsatisfied basic needs and emotional eating, including the mediating factors of self‐esteem and coping strategies. The results from a survey of 136 obese individuals indicated support for a significant relationship between basic need satisfaction and emotional eating, with a mediating effect of negative coping strategies. These findings extend previous research and provide guidance on how to help individuals who engage in emotional eating by focusing on developing more adaptive coping strategies.     

Self‐supervision,surveillance and transgression

Transgression is not only an inevitable part of systemic supervision but is also necessary if we are to work towards innovative and inclusive supervisory and therapeutic practice. Defying culturally generated ‘rules’ of systemic practice can allow for more relevant and productive ways of talking. Systemic practitioners are increasingly finding themselves trying to practice systemic therapy in employing authorities and training courses which are dominated by inflexible professional narratives and manualised procedures. Our profession is committed to ethical inner and outer dialogue, to self‐ and relational reflexivity as distinct from the rule‐bound surveillance culture in which we live and work. Systemic supervisors and therapists may find themselves at odds with monological institutional discourse and attempts from within our own profession to manualise practice. I introduce examples from supervisory conversations to illustrate how supervisors can develop more culturally sensitive practices through supporting practitioners to hear and have heard their own marginalised and oppressed voices and those of their clients.