A systematic review of the literature on counselling and psychotherapy for the prevention of suicide: 1. Quantitative outcome and process studies

Scope of review: The paper reports a meta‐review of 15 previous systematic reviews and meta‐analyses of the literature concerning the outcome of counselling and psychotherapy with people at risk of suicide; a meta‐analysis of 67 outcome studies in this area; and a narrative review of 17 studies of the therapeutic process. Publication time span: The literature reviewed was published between 1981 and 2008. Publication origin: The majority of the literature reviewed was by authors from the USA or the UK, but there were also authors from other European countries, Australia, Canada, India, and Sri Lanka. Findings: There is evidence of the effectiveness of dialectical behaviour therapy, cognitive‐behavioural therapy, and problem solving therapy, but also for other forms of therapy. Therapist and client variables, as well as the therapeutic relationship, appear to be related to treatment outcome. Conclusions: People at risk of suicide should have access to psychological interventions, including, but not necessarily limited to, those within the cognitive‐behavioural spectrum. Therapies for which there have been promising findings, but which are under‐researched, should be a research priority.     

Work-related counselling-a psychodynamic approach

Abstract

The paper sets out to stimulate interest in counsellors and therapists about the unconscious relationships which people form with their work, through describing and analysing what goes on in work-related counselling with a psychodynamic approach. The author draws on twenty-five years of experience to reflect on the changing nature of what was once termed ‘vocational guidance', and offers some short case studies, as examples of ways in which a person's world of work can become intertwined with their internal world in a confusing and disabling way. The core concepts and techniques which have evolved are identified and discussed; attention is directed particularly to the importance of the client's expectations, die effect of time limitation, the place of work in the whole life, and dealing with transference.     

The Power of Feelings

Abstract

The relationship between myth, the dream, narrative and career are explored in order to understand better the underlying factors that influence career development and will thus inform the work of career counsellors. A case study is used to illustrate how these insights can be used in practice.     

Experiences in difference: An exploration of the usefulness and relevance of psychoanalytic theory to transcultural mental health work

Abstract

This paper presents accounts of work with mental health service users in a multicultural residential setting and, explores some of the difficulties involved in working from a psychodynamic perspective in such a setting. It argues that a psychoanalytic understanding of the role of phantasy in the experience of difference, upon which ideas of culture and identity are constructed, can be helpful to practitioners concerned with addressing the consequences of their clients' experience of racism and other forms of discrimination. Particular reference is made to Winnicott's writings on play, transitional space and the location of cultural experience.     

The advantages and disadvantages of a brief intervention strategy in a community counseling service

Abstract

The Isis Centre, a long-established NHS open-access counselling facility in Oxford, experienced excessive demand for service. This placed strain on the capacity to deliver, and an unacceptably long waiting list resulted. A brief intervention strategy limited to four counselling sessions was shown to reduce the waiting time. This outcome study tests the hypothesis that the strategy was sufficiently clinically effective to warrant its continuing availability to those who wished to be seen more quickly, rather than waiting for an open-ended contract. Counsellors assessed outcome on clinical parameters and clients were retrospectively asked their views on the acceptability of the method and its usefulness.

There was a high level of correlation between clients' and counsellors' assessment. One-quarter of the study group had an experience classified as ‘useful and sufficient’. However, half felt the experience ‘useful but insufficient’, although this group also thought the intervention provided more than temporary relief. For one quarter, the experience was not helpful, but for some of these it prevented a long, unnecessary time on the waiting list.

While a brief intervention appears to be an effective strategy in delivering a counselling service, further work is necessary to target those most likely to benefit and those for whom a longer-term option should be sought from the start.     

Introducing counselling in secondary schools: A case study with reference to frame issues

Abstract

I am a deputy headteacher in a comprehensive school. I believe that the widespread re-introduction of counselling into secondary schools offers possibilities for great benefit, both in terms of the personal well-being and emotional health of students, and also in terms of academic results and other educational indicators. It is my view that, currently, this may particularly be true for boys.

This paper is a double case study: first, of the failure of a student to cope with ordinary schooling because of his emotional difficulties; and, second, of the establishment of a counselling service which resulted from his permanent exclusion from the school.

I allude to some of the theoretical issues which meshed with the practical details of establishing the counselling service, and offer some tentative conclusions about the rationale for counselling in secondary schools and the kind of model which seems most likely to be beneficial.     

Private selves and shared meanings: Or forgive us our projections as we forgive those who project into us

Abstract

This paper explores the difficulty university counselling services experience in finding common purpose with their institutions at the present time. It draws on a review of the relevant literature and personal experience to argue that it is extremely difficult to sustain depressive-position functioning in the current organizational culture, which, the author suggests, is dominated by fears about survival. The paper examines some defensive strategies counsellors may use to protect themselves against prevailing anxieties and argues for the importance of recognizing and working with these.     

Japanese Children's Reactions to Family Photographs: Associations with Mothers' Attachment Status

This study examined differences in children's responses to their family photographs within a sample of Japanese 6‐year‐olds (N = 44), exploring associations with their mothers' attachment status. The differences in children's photo reactions were captured by a 5‐point continuous scale to rate how engaged children were and how positively they responded to the photographs taken earlier with their mothers. Mothers' attachment security was assessed by the Adult Attachment Interview. The findings revealed that children of mothers with secure attachment status were significantly more engaged/positive in their photo reactions than were children of mothers with insecure attachment status. Implications of the findings and future research directions are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

A Solution-Based Approach to Couple Therapy

Abstract

Couples often present for counseling as a last resort. As relationships in crisis may not last it is important that treatment be time-effective. Solution-based therapies have been described as brief and time-effective and applied effectively to working with couples. This article presents a case example demonstrating the application of a solution-based approach to therapy with a married African-American couple entering therapy to resolve their relationship difficulties that lead to the initiation of divorce proceedings. The processes of reducing blame and conflict, creating hope and solution building utilizing solution-based interventions are discussed, as well as the treatment outcomes.     

Feminist Issues in Couple Therapy

Abstract

The authors reviewed the feminist couple therapy literature from 1995 to 2006. They summarized this large body of work into several key themes. The first revealed that feminist couples therapists are continuing to discuss and deconstruct gender issues in couple therapy. The second showed that feminists believe that therapists should be educated both academically and personally about culture and diversity so as to support couples in their therapy around their own issues of diversity as well as learning to deal with issues of social justice as a couple. In the third theme, the authors introduced readers to feminists' emphasis on connection and empathy within couple and sex therapy. And, in the fourth, the authors explored feminists' work with power in couple therapy as they applied to couple therapy in general as well as around the specific topics of: balancing family and work and therapy for familial violence.