‘What made me unhappy’. Experiences of,and responses to,lifestyle changes in breast cancer patients

Sixteen breast cancer patients were interviewed about any lifestyle changes they had experienced and their reactions to those changes. Data were collected and analysed via content analysis and then summary tabulations of patient responses until replication of responses was verified across patients. Results indicated that most patients suffered a reduction in recreation activities, unpleasant physical side effects from treatment and loss of feminine appearance characteristics, all of which were seen as decreases in previously available and valuable sources of social support and self-esteem. In response to these losses, patients reported a common coping strategy of avoidance or escape similar to some depressive symptomatology. Implications for counsellors are discussed.     

Factors affecting the involvement of teachers in guidance and counselling as a whole-school approach

This study explores factors affecting the involvement of regular secondary school teachers in the whole-school approach to guidance and counselling by interviewing 12 secondary school teachers in Hong Kong. Emerging themes include teachers' ownership of their role in student guidance and counselling, the alignment of their disposition with education policies, school missions and culture, and their philosophy in education. Findings of what these teachers are actually doing in guidance and counselling are presented. Implications for policy-makers, administrators and leaders for comprehensive guidance and counselling programmes are drawn from constraints that limit interviewees' full potential in assisting students.     

Therapists' views of the relative benefits and pitfalls of group work and one-to-one counselling for bereavement

Aim: To explore therapists' perceptions of the relative benefits and pitfalls of group work and individual counselling for bereaved clients. Method: Semi-structured interviews with nine experienced bereavement therapists from a range of different contexts generated data which was analysed using grounded theory methodology. Findings: Groups were perceived as having a normalising influence, helping members make new social contacts and practice social skills. Individual counselling was seen as facilitating the initial telling of the story and the expression of extreme emotion. Discussion: The findings suggest that individual counselling may be useful as a primary intervention easing ‘emotional loneliness’ caused by the death of a spouse or attachment figure. Group work may be of more benefit later in the bereavement process, facilitating an engagement with the outside world and alleviating ‘social loneliness’. Implications for practice: This suggests that bereavement services might usefully combine group and individual provision. Initial assessment could help clients clarify their needs and facilitate their choice of service. This would be more cost effective and potentially ease clients' bereavement experience.     

The influence of Confucianism: a narrative study of Hong Kong teachers’ understanding and practices of school guidance and counselling

School guidance seeks to promote the whole person growth of students. It is regarded as an integral part of an educational programme. In Hong Kong secondary schools, a team of teachers are responsible for school guidance. This article examines how guidance teachers made sense of their caring work in general and specifically the counselling services they offered to students. With the use of a narrative analysis and personal experience methods, the study explores the experience of guidance teachers in counselling. Twelve in-service teachers who had enrolled in the Postgraduate Diploma in Education programme at the Hong Kong Institute of Education were interviewed. The influence of the Chinese philosophy of Confucianism, emerging as a theme from the data, was prominent, as its key principles were incorporated into the teachers’ personal systems of counselling. The findings illuminate the influence of Chinese culture in Hong Kong schools. Implications for the promotion of culturally responsive approaches to counselling and culturally competent practices for helping are discussed.     

Training clinical psychologists for rural and northern practice: Transforming challenge into opportunity

Abstract: The Rural and Northern Program (R&NP) of the University of Manitoba's Department of Clinical Health Psychology (DCHP) is a unique training and service delivery platform that was developed in response to the scarcity of psychological services in rural and northern areas of the province of Manitoba, Canada. Since 1996 rural and northern‐based psychologists, in conjunction with the faculty based in Winnipeg (Manitoba's largest city) have offered training to two interns and one postdoctoral resident (resident) yearly. The current article discusses the nature of the program, the regions of Manitoba that the program services, and recruitment and retention data. The authors conclude by offering suggestions for creating sustainable rural/northern psychological practice.     

“Not a little Mickey Mouse thing”: How experienced counselling psychologists describe the significance of personal therapy in clinical practice and training. Some results from an interpretative phenomenological analysis

The British Psychological Society's Division of Counselling Psychology currently specifies a mandatory period of personal therapy for trainees. However, evidence for the role of personal therapy in developing practitioner competence is sparse. This paper presents part of a wider ongoing interpretative phenomenological analysis exploring how counselling psychologists describe the meaning and significance of personal therapy in clinical practice and training. Detailed examination of a subset of data from this study suggests that personal therapy is valued as a vehicle for a genuine, often extremely intense relationship with the therapist, through which participants become able to establish authentic emotional contact with themselves and their clients. Whilst most participants felt that personal therapy should remain an obligatory part of the training curriculum, they were ambivalent about specifying its aims or evaluating its outcomes. Results are discussed in terms of the importance of establishing a sense of integrity and authenticity within the personal therapy experience and are tentatively situated within a possible theoretical framework drawing on current developmental literature.     

Towards an integrated identity in counselling psychology: Graduate,professional and academic experiences

The paper is a reflective summary of my identity as a counselling psychologist. It discusses personal life, work and training experiences. The reason I would like to publish such a work is to encourage students in Greece, where the field of Counselling Psychology is less developed, to consider this kind of specialization, as well as to continuously enhance their professional identity, assimilating both practice and research opportunities, throughout their career paths. The paper focuses on three major influences in my development and training in the field: (a) graduate experiences as a doctoral student, writing a thesis on women's professional development, (b) work experiences in a career center of a large academic institution, and (c) academic and instructional experiences in a School of Psychology, where I teach and supervise research of both undergraduate and graduate students. The above influences delineate three separate, yet integrating identities: the identity of a feminist, the identity of a practitioner, and the identity of a researcher and instructor in the academia–that is, the identity of a scientist. My intention is to show how these three identities have been well integrated all these years, improving continuously my level of work in each and every dimension.     

The Teaching Alliance Inventory: Evaluating the student-instructor relationship in clinical and counselling psychology training

The Teaching Alliance Inventory (TAI) was developed to measure the quality of the student-instructor relationship in graduate clinical and counselling psychology classrooms. Based on Bordin's (1983) original concept of the alliance as fundamental to the change process in psychotherapy, we developed the TAI to measure aspects of the classroom relationship that may be fundamental to learning essential skills of counselling and clinical psychology. Factor analysis revealed six subscales, four representing interpersonal variables not evaluated in traditional teaching effectiveness measures. We demonstrated internal consistency and split-half reliability with a large sample of graduate students and described evidence for the scale's face validity and content validity. Construct validity was supported by significant correlations between the TAI and its subscales with an established measure of teaching effectives and its logically related subscales (SEEQ; Marsh, 1987 Marsh, HW. 1987. Students’ evaluations of university teaching: Research findings, methodological issues, and directions for future research. International Journal of Educational Research, 11(Whole Issue 3): 253–288.  [Google Scholar]). The TAI may supplement traditional assessments of instructor quality by providing feedback regarding interpersonal impact in the classroom.     

Counselling in primary care: a systematic review of the evidence

Primary objective: To undertake a systematic review which aimed to locate, appraise and synthesise evidence to obtain a reliable overview of the clinical effectiveness, cost‐effectiveness and user perspectives regarding counselling in primary care. Main results: Evidence from 26 studies was presented as a narrative synthesis and demonstrated that counselling is effective in the short term, is as effective as CBT with typical heterogeneous primary care populations and more effective than routine primary care for the treatment of non‐specific generic psychological problems, anxiety and depression. Counselling may reduce levels of referrals to psychiatric services, but does not appear to reduce medication, the number of GP consultations or overall costs. Patients are highly satisfied with the counselling they have received in primary care and prefer counselling to medication for depression. Conclusions and implications for future research: This review demonstrates the value of counselling as a valid choice for primary care patients and as a broadly effective therapeutic intervention for a wide range of generic psychological conditions presenting in the primary care setting. More rigorous clinical and cost‐effectiveness trials are needed together with surveys of more typical users of primary care services.     

The client as expert: Researching hindering experiences in counselling

This paper identifies the importance of valuing clients’ experiences when seeking to understand hindering experiences in counselling. Since the research literature reports that client perceptions of counselling are better predictors of outcome than counsellor ratings, client viewpoints are critical to furthering understanding of hindering experiences. Clients are generally reluctant to share negative experiences and a discussion regarding the difficulty in soliciting these experiences is presented. Examples of the process of conducting a client-oriented investigation into hindering experiences convey some of these difficulties. Several implications for counselling practice are addressed: (1) the need for counsellors to notice and repair hindering experiences, (2) the value of attending to the quality of the relationship, (3) the need for counsellors to cultivate flexibility and responsiveness, and (4) the use of methods to encourage clients to share their unspoken experiences.