Formative evaluation of the transition to postgraduate study for counselling and psychotherapy training: Students' perceptions of assignments and academic writing

Background: Transition to postgraduate study has received little attention and it is often assumed that little adjustment is needed. Focus: This article focuses on the academic writing aspect of the transition to postgraduate study for counselling and psychotherapy students on a British Association for Counselling and Psychotherapy (BACP)‐accredited course. Method: A two‐year formative evaluation was used to elicit students' views on how they experienced the transition to postgraduate study, and to identify what was most and least helpful to students in managing this transition. Results: The findings showed that there was a significant transition, which 63% of students found difficult. Timetabled and integrated, subject specific, academic support is recommended to assist students with their learning needs.     

Motivation as a predictor of outcomes in school‐based humanistic counselling

Background: Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school‐based counselling services. Aims: To assess the relationship between young people's motivation for counselling and its effectiveness within a secondary school setting. Sample: Eighty‐one young people (12–17 years old) who attended school‐based humanistic counselling services in Scotland. Method: Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Results: Motivation for counselling was not found to be significantly related to outcomes. Discussion: The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non‐significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects.     

Counselling and psychotherapy,complementary and alternative medicine and the future of healthcare

The counselling and psychotherapy profession is undergoing considerable change as a result of government intervention in the form of regulation, funding and efficacy research. In this paper we argue that these changes, even though they challenge some of the basic ways of thinking which have come to underpin the profession since its inception, also offer an opportunity to stimulate debate and thought in regard to how the profession might contribute to the development of healthcare systems in the future. We argue that this could be enhanced if therapists can learn from the experience of practitioners in the field of complementary and alternative medicine (CAM), which has been experiencing similar changes in recent years. Indeed, both fields of clinical activity adopt many similar underlying clinical principles and, according to Samuels (2001), have similar political outlooks. With reference to anthroposophic psychotherapy which, as well as being a form of psychotherapy, is also part of a ‘whole systems’ approach to CAM, we will examine those characteristics of psychotherapy and CAM that can inform the thinking of healthcare systems as a whole.     

心理治疗与普通医疗的平等性

心理治疗与普通医疗的平等性是美国心理健康服务系统面临的一个主要政策问题,强调健康保险应为心理健康和物质滥用障碍提供与普通医疗相同的承保范围。近20年来,平等性立法在美国得到了较快发展,并取得了一定效果。但由于立法本身存在的局限性及心理健康服务需求与提供双方的多重因素影响,平等性立法的实施及对其效果的评估仍存在一定困难。借鉴平等性立法的经验,得出了一些关于我国心理健康服务发展的启示。     

Psychiatric diagnoses, ‘thought styles’, and ex post facto fact fallacies

Living in two-way, dialogical relations with our surroundings, rather than in monological, one-way causal relations with them, means that we can no longer treat ourselves as inquiring simply into a world of objective ‘things’ already existing in the world around us. We need to see ourselves instead as always acting ‘from within’ a still-in-process world of flowing streams of intermingling activities affecting us as much, if not more, than we can affect them. In such a world as this, instead of discovering pre-existing things in our inquiries, we continually bring such ‘things’ into existence. So, although we may talk of having discovering certain nameable ‘things’ in our inquiries, the fact is, we can only see such ‘things’ as having been at work in people’s activities after they have performed them. This, I want to argue, is also the case with all our diagnostic categories of mental distress – thus to see the ‘things’ they name as the causes of a person’s distress is to commit an ex post facto fact fallacy. Something else altogether ‘moves’ people in the performance of their actions than the nameable ‘things’ we currently claim to have discovered in our inquiries.     

Repurposing process measures to train psychotherapists: Training outcomes using a new approach

Aims: First, this paper presents the rationale for a novel approach to training counsellors in which measures for psychotherapy process research are taught to students before moving on to teaching basic empathic reflections and interventions. The rationale for this is that client process measures can be re‐purposed to help orient and sensitise trainees to key in‐session moments. Second, we present a training outcome study that assesses the effectiveness of this approach. Method: Using an experiential‐integrative therapy approach, a 13‐week training program was used to teach psychotherapy skills and process research measures to22 clinical graduate students taken from two cohorts. As part of the course, trainees conducted several single sessions with volunteer clients on four separate occasions. Training outcomes were measured using both trainee and client reports. Results: Compared to baseline, therapists reported significant and steady gains (all p's<.05) in session management, reducing their anxious self‐awareness, and in improved sense of self‐efficacy, with the latter having the largest effect (partial Eta Sq.=.381). Discussion: While the findings provide some support for a new training strategy, a dismantling design is needed next to more closely examine the process‐measure approach to training.     

Roth and Pilling's competence framework for clinical supervision: How generalisable is it?

Background: Roth and Pilling's (2009) competence framework for the supervision of psychological therapies was commissioned as a training resource for the UK Government's ‘Improving Access to Psychological Therapies’ (IAPT) programme. Aims: This paper considers the extent to which it reflects current supervisory practice in the UK. Method: Supervisors' opinions of the non‐modality‐specific competences were surveyed using an online survey form and two emailed survey forms. Findings: Regardless of their professional background, participants felt able to identify with the majority of competences surveyed; however, a minority elicited disagreement. Here, findings suggest that those who drew on cognitive and/or behavioural theory, and were members of the British Association for Behavioural and Cognitive Psychotherapies (BABCP) might be more confident in their ownership than others. However, small sample sizes in the email surveys prevent firm conclusions from being drawn. Conclusions: Regardless of the theoretical approach they subscribe to, supervisors should find the framework helpful as a guide to best practice.     

Shame and violence in ‘Starred Up’

Shame plays a powerful role in triggering violence, sometimes with fatal consequences. It is fundamentally important to understand and treat the roots of this aggression and its links to an internal sense of shame. In this paper, I will discuss the contribution of forensic psychotherapy to this project and link it to the excellent depiction of violence, shame and the development of insight and impulse control through psychotherapeutic work in the powerful film, ‘Starred Up’, written by Jonathan Asser and directed by David Mackenzie. At the 2015 Birkbeck summer conference, I was asked to speak to the themes of the film and relate them to my work with violent male offenders and their psychotherapeutic treatment. As a clinical and forensic psychologist and forensic psychotherapist, I have been heavily involved in assessing and treating men and women with violent histories in prisons, mental health services and community settings over the past 25 years. I see the film through the lens of forensic psychotherapy, filtered by my own clinical encounters. I discuss its main themes in relation to the challenges and possibilities of the therapists who work with men with entrenched violence and the underlying issues at stake for the men themselves.     

Photography: snapshots out of the unconscious

Abstract

This paper looks briefly at the relevance of infant and young child observation courses to work with adults and then goes on to describe how a normal young child aged 2% coped with two quite sudden changes in her life and the psychological mechanisms she used to manage her anxieties. These mechanisms - displacement, use of transitional objects, fantasy and symbolism - might equally be used by adults in later life when faced with uncertainty and change. Links are then made to psychotherapeutic work with adults.     

Relational Psychoanalysis: A Review

Relational psychoanalysis, a relatively new and evolving school of psychoanalytic thought, is considered by its founders to represent a “paradigm shift” in psychoanalysis. The relational approach, initiated by the publication of Jay Greenberg and Stephen Mitchell's book, Object Relations in Psychoanalytic Theory in 1983, has developed into a movement with its own substantially separate literature. This paper reviews both the history and theoretical origins of the relational movement, as well as important theoretical premises and viewpoints now associated with the relational school.