Showing papers in "Counselling Psychology Quarterly in 1999"

Burnout in counseling psychologists: Type of practice setting and pertinent demographics

Abstract: Extent of burnout experienced by conseling psychologists and the relationship between levels of burnout and different types of practice settings, selected demographic and work-related variables were investigated in this study. Burnout was defind in terms of the Maslach Burnout Inventory (MBI) subsxales. Multiple regression anslyses were perforned on the data (n = 521). Counseling psychologists in private practice reported the lowest levels of burnout, while those employed in hospital settings reported the highest levels of Burnout. A positive relationship was found between hours of client contact per week and sense of personal accomplishment. Finally, an inverse relationship was reported between age and burnout, and males experienced greater depersonalization of clients than females.

Intentionality and awareness: A qualitative study of clients' perceptions of change during longer term counselling

Abstract: This study exlores the experience of clients in longer term counselling from the point of view of changes perceived by the clients to themselves and their outlook; and their understanding of how these changes have come about. A brief overview of some relevant literature is provided. Unstructured interviews were carried out with four clients who were seen as having been successfully involved in counselling. Transcripts of the interviews were subejcted to grounded theory analysis. An analysis of the emerging categories of data is given followed by a discussion in relation to other counselling research. All clients seemed tio feel more in control of their lives, this involving a complex of factors, specifically: increased self-awareness; confidence; insight; ability to make decisions and act to influence events; and assertiveness. All clients attributed these changes in large part to counselling. Contributions to the change process seem to come from aspects of the counsellor-client relationship (not...

Student mental health : a pilot study

Abstract: In this country, little research has been undertaken into the difficulties faced by students and the contributory stressors. It is apparent that they have a lot with which to content. Identification of stressors, assessement of stress levels and consequences on mental health appear vital.A pilot study was undertaken of 40 studets: 10 males aged under 21 years, ten males 21–40 years, 10 females under the age of 21 and 10 females 21–40 years, The purpose was to identify the potential factors leading to student discontent, problems and stress. Students were in the professions allied to medicine. Oral semi-structured interviews and a written questionnaire were used. Results indicated that for students the major difficulties were coursework and emotional state. Finance was a recurring problem but not as troublesome to the students as the other two problems. What must be considered are ways to alleviate student unhappiness. Emphasis should be placed on prevention where possible. Ongoing counseling thro...

Distress and coping with hot flushes at work: Implications for counsellors in occupational settings

Abstract: This study explored whether mid-life women regard hot flushes at work as a substantial stressor. A sample of 29 working women reporting hot flushes for at least 12 months rated the degree to which each of ten work situations influenced flush distress or discomfort. Ratings were compared with qualitative accounts of coping with flushes at work. Results showed that women differed markedly in the work situations that they regarded as most problematic, but flush distress was commonly magnified during formal meetings, in hot enclosed spaces and in the presence of male colleagues. A substantial minority viewed colleagues as conveying negative attitudes towards menopausal problems, which jeopardised general confidence at work as well as creating specific difficulties during frush episodes. Flush distress was higher among those reporting embarrassment and dificulties disclosing menopausal status to others. Respondents made suggestions for ways in which the working environment could be improved to assist ...

A narrative social constructionist approach to therapeutic empathy

Abstract: The concept of empathy has been a centrol conceptual element in approaches to counselling and psychotherapy that emphasise exploration of meaning in the context of a facilitative relationship. However, the existing literature on therapeutic empathy lacks theoretical coherence. a narrative social constructionist perspective represents a theoretical approach that enables the integration of diverse strands of clinical observation and research into the creation of empathic understanding in counselling. From a social constructionist position, therapeutic empathy can be understood as a relational process, a step-by-step co-construction by counsellor and client of the life-narrative of the client. In this paper, the Barrett-Lennard (1981) cyclical model of empathy is used as a fremework for examining the counsellor and client actions, strategies and tasks that constitute empathic engagement around the task of emploring and re-authoring life-narratives. Constructionist analysis of the cultural origins of...

The experience of ‘healing stories’ in the life narrative: A grounded theory

Abstract: ‘healing stories' are part of an emergent narrative literature in psychology and counselling. This research explored the subjective experience of ‘healing stories’ within the context of individual's life narratives. A grounded theory (Strauss and Corbin, 1990) method of analysis was used to generate and analyse six participant's life narratives. Analysis of these accounts revealed three categories. The first is the context of struggle that preceded the healing process. participants told of struggle in their relationships with others as well as turmoil in their experience of themselves. The second category, the healing process reflected the participants' growing awareness of life's existential givens (Yalom, 1980). This represented a personal exploration that opened lparticipants to a ‘healing story’ that offered them an insight into choices and possibilities for liberation. The third category illustrated that in the ongoing struggle the ‘healing story’ has continued to provide inspiration in the ...

Coping strategies for auditory hallucinations: A review

Abstract: This article reviews the literature on the strategies which psychiatric patients spontaneously use in order to cope with their auditory hallucinations. The common strategies found between studies are described and these are grouped according to four categories: (i) social contact; (ii) sensory stimulation; (iii) physiological arousal; and (iv) cognitive strategies. An attempt is made to relate these strategies to the theoretical and experimental literature on auditory hallucinations and, finally, the role of the counselling psychologist in fostering the development of effective coping strategies is outlined.

Living with obsessive-compulsive disorder: A case study of a woman's construction of self

Abstract: This qualitative case study employed social constructionist theory and a discursive or language-based approach to examine aspects of identity and subjectivity in one woman's account of living with obsessive-compulsive disorder (OCD). Two, 2-hour semi-structured interviews were conducted, 6 weeks apart. In the first interview, the participant was asked to tell her ‘story’ of what her life with OCD was like. A discursive analysis focusing on the woman's construction of self was conducted on her narrative. During the second interveiw, the participant was asked to give her reactions to the analysis and to provide further interpretations and/or explanations which were then discussed. The results indicate how different ‘voices’ in the woman's narrative represent the power relations involved in her self-presentation of life with OCD within a particular social and discursive context. A key discourse involving religion as a metaphor was also identified as a way of representing the woman's experience of OC...

Prevention, not treatment, is the only hope

Abstract: If our goal is the reduction or elimination of emotional disorders in our country, or in the world, a major social revolution is required. Individual psychotherapy is available to a small number only. No mass disorder has ever been eliminated by treating one person at a time. Psychotherapy is useful in teaching the possibility of unlearning damaging habits and thus it contradicts the organic-brain disease model advanced by political conservatives. Organic explanations of mental disorder find causes inside the person and ignore or deny the pathological environments of poverty, racism, sexism and exploitation. The organic model is supported by corporate power and conservative citizens' groups. It is time for radicals to come together to expose the power elite for its control of invalid ruling ideas.

Psychological therapy for adults with Attention Deficit Hyperactivity Disorder

Abstract: In the liteature, the clinical management of adults with Attention Deficit Hyperactivity Disorder has focused almost exclusively on stimulant medication. Yet psychological therapy may be a useful adjunct to stimulant medication. Pharmacotherapy is generally reported to be efficacious and, as such, treated individuals are likely to be more receptive to psychological intervention. The aim of this paper is to consider how an individual may best be supported by psychological therapy. It is recommended that a structured pragmatic, psychoeducative approach is the most appropriate. The development of specific self-management skills is discussed within a cognitive behavioural framework. Family, marital and group therapies are also discussed.

The personal and professional development of the counsellor: The relationship between personal philosophy and theoretical orientation

Abstract: This paper examines the relationship between visions of reality held by counsellors and their professed theoretical orientations. It is suggested that there exist a number of states of congruence between the tow variables and that there are potential problems when the two are not in harmony. The implications for the training and continued professional development of counsellors are explored. Finally, Some provesional findings are offered from the authors' own research.

Therapeutic work with refugees living in exile: Observations on clinical practice

Abstract: Asylum seekers and refugees fleeing to Britain or other host countries face a range of dilemmas, which are qualitatively different from those facing any other client group. Refugees find themselves in an entirely different country, having often fled at short notice without making preparations. They may have suffered multiple practical and psychological losses. Significant numbers of refugees will have been subject to organised violence in their country of origin. Responding clinically to the needs of some of those becoming refugees has many implications and challenges for existing models of therapeutic intervention. This paper draws upon the author's clinical work in Britain and abroad, it details some observations on therapeutic practice and highlights the challenges and rewards of working with this client group.

The influence of personality and theoretical models on applicants to a counselling psychology course: A preliminary study

Abstract: We examined whether personality variables in prospective candidates for a postgraduate program in counselling psychology were associated with an interest in models of counselling or therapy. The models were classified as directive models or non-directive models of counselling. Using the Millon Index of Personality Styles we found that subjects who expressed an interest in the directive models of counselling (e.g. cognitive behavioural therapy) scored higher on scales measuring interpersonal boldness, systematizing and conforming in comparison to subjects who expressed an interest in non-directive counselling (e.g. psychodynamic) who scored greater on intuitiveness (a preference for intangible, unstructured and symbolic). Implications for training and future research in this area are discussed.

Counseling dropout relative to client attractiveness, disturbance, and expected number of sessions

Abstract: Participants were 12 counseling center psychologist and thir 257 college-student clients. Immediately after intake, clients indicated whether or not they would make an additional appointment, their reasons for not making another appointment, and the estimated number of sessions they would attend. Counselors rated clients' attractiveness and disturbance and estimated the number of sessions they would have with each client. Clients who did not make a second appointment were generally satisfied with the help they received in one session. Client estimates were more predictive than counselor estimates of actual number of sessions. Relative to less attractive and disturbed clients, more attractive and disturbed clients made and kept post-intake appointments.

Measuring counsellor theoretical orientation

Abstract: Previous studies of counsellors' and psychotherapists' theoretical orientations have suggested the importance of two superordinate dimensions of beliefs about therapeutic practice: an analytical-experiential dimension and an objective-subjective dimension. A 40-item measure was developed which tapped both these. A study involving 132 counsellors found evidence that the Counsellor Theoretical Position Scale is a reliable and valid measure of important aspects of theoretical orientation to counselling practice.

Measures of effectiveness in a short-term Interpersonal Cognitive Problem Solving programme

Abstract: The effects of a classroom-based, short-term Interpersonal Cognitive Problem-Solving programme for 24 7- and 8-year-old children were assessed immediately after a 4-week intervention programme and again after a 4-week follow-up period. A previous study (Erwin & Ruane, Counselling Psychology Quarterly, 7, 305–310, 1993) implementing such a short-term programme relied on sociometric testing to measure the social effectiveness of the training and failed to find any changes in social status. The present study incorporated playground observations and found behavioural improvements immediately after training and after the follow-up period for the experimental group. However, confirming the previous study, no significant differences in sociometric status were found. The results highlight the limitations of sociometry as a measure of the effectiveness of a programme of training in Interpersonal Cognitive Problem-solving.

Judgement of control revisited: Are the depressed realistic or pessimistic?

Abstract: The study, firstly, examined the depressive realism postulate in relation to control judgments. A group of depressed and nondepressed undergraduates were exposed to a total of six judgement of control tasks (from 0% control tio 100% control). Depressed and nondepressed subjects did not differ in their control judgements. Secondlym, an attempt is made to classify subjects on the basis of these six judgements of control tasks as optimisticm, realistic and pessimistic in perceived control judgements.It was found that pessimistic rather than realistic subjects, had higher depressive symptomatology. Lastly, pessimism about control predicted the depressive symptomatology as assessed three months later. The results are discussed in relation to the phenomenon of depressive realism and the hopelessness theory of depression.

Towards an integration of science, art and morality: The role of values in psychology

Abstract: The purpose of this paper is to define the role of values in therapy. From both an historical and theoretical perspective, values are an integral part of the therapeutic process. Hence, a review of the research which highlights the effects, interplay and outcome of values in psychology is undertaken. The implications of this review are discussed with particular reference to cross-cultural and religious issues. The current trend for ‘value-free’ therapy is suggested as unattainable and, moreover, as reflective of the dominant sociopolitical structure. In addition, the impact of this research on the role of the professional is explored and the possibilities of future research highlighted. In sum, psychology is discussed as a value-laden process which needs to better integrate the science, art and morality of the discipline if it is to fulfill its potential as a therapeutic process.

Unfinished business in gestalt reminiscence therapy: A discourse analytic study

Abstract: This paper explores the identification and exploration of ‘unfinished business’ in gestalt reminiscence therapy with older adults. The theoretical basis for this integrative approach is briefly outlined, and extroacts from a transcript from a six year long ongoing project in the South of Ireland are used to illustrate the occurrence and processing of unfinished business in therapy. An audio-tape of a particular session on the theme of ‘Feelings’ was transcribed using a modified Jeffersonian approach as outlined in Potter and Wetherell (1987). The transcript was read critically for the identification and selection of any ‘unfinished business’ by a panel of three judges, and the chosen excerpts were then analysed using the discourse analysis method.

Stress and its perception in childhood

Abstract: This paper examines how children may perceive events as stressful, and identifies some of the elements which may contribute to this perception, The proposition that this perception is dependant on individual phenomenology will be investigated Various models that attempt to explain this phenomena will be presented and a synthesized paradigm offered

Incidence and impacts of psychotherapists' feelings toward their clients: A review of the empirical literature

Abstract: The empirical literature examining the incidence and impacts of psychotherapists' feelings of fear, anger, and attraction toward clients is reviewed, including: (a) studies reporting the incidence of psychotherapists' feelings toward their clients; (b) studies investigating the measurable impact of psychotherapists' feelings on clients, psychotherapists, and the therapeutic process; and (c) examinations of the psychotherapist-factors that affect either the incidence or impact of psychotherapists' feelings toward their clients. Fear, anger, and attraction toward clients are common experiences for psychotherapists. Many psychotherapists report that they are confused, ashamed, and stressed by these feelings. These feelings, although occasionally an important therapeutic resource, were often reported to have a direct and negative impact on the therapeutic processes or cause behaviors that were destructive. Most psychotherapists feel that they were inadequately trained to acknowledge and successfully ...

AIDS-related death: A review of how bereaved gay men are affected

Abstract: This paper reviews the current literature in relation to how gay men are affected by AIDS related bereavement. It seems that bereavement reactions have changed as the epidemic has progressed. Initially, it seemed that gay men were very badly affected by AIDS related bereavements, especially the experience of multiple bereavements. However, while the experience of such bereavement cna be vary stressful it seems that gay men are less afected in the long term than was previously thought. The paper places this change within a cultural and political context and user this context to consider current bereavement reactions.

Danger! Psychotherapists at work

Abstract: The rapid growth of psychotherapeutic movements in recent years has led to a free market. Vast numbers of psychotherapists of different theoretical persuasions are now on offer. While such a choice has its obvious advantages, it creates bewildering confusions in the minds of potential clients. How can the clients tell which psychotherapist or psychotherapeutic entepise to opt for? How can they know whether they have made an appropriate choice? How do they know which therapy works best under which conditions? Are there a set of criteria laid down which might guide the client in making a judicious choice? Can they be assured that after a senes of agreed sessions, they will get better? These are extremely serious issues. The paper discusses the practical and ethical implications underlying these issues and offers specific suggestions and guidelines as to how the clients might safeguard their own interests when it comes to choosing an appropriate psychotherapist.

Sponsored research in the counseling psychology literature

Abstract: Elliott and Shewchuk (1996) assert that counseling psychology should have considerable potential to influence national healthcare and public policy. A mechanism for realizing this potential entails being responsive to national, state and private funding initiatives for reaearch and other programmatic activities. To examine the extent to which counseling psychology resarch reflects an involvement in these initiatives, we studied the rate of sponsored research in three journals traditionally associated with mainstream counseling psychology research. We compared this rate with that observed in oher applied and theoretically oriented psychological journals. In comparison with the research published in the other outlets, results indicated that the mainstream counseling psychology literature has a disproportionately low level of sponsorship from national and federal sources. The scant representation of federally-funded research in the counseling psychology literature may effectively preclude full parti...

A process model of ethnocultural counselling for African survivors of organized violence

Abstract: By analysing some 500 counselling and psychotherapy cases of survivors of organized violence as a therapist and supervisor over ten years the author developed a heuristic framework for a process model of ethnocultural counselling considering: (1) African counsellor's indigenous concepts, (2) a WHO-UNHCR approach, (3) a heuristic approach to psychotherapy, (4) a constructive narrative perspective, (5) an ethnopsychotherapeutic approach, and (6) a counselling approach for lay counsellors. The counselling process model comprises the following components: (1) Establishing a counselling relationship and motivation for change; (2) defining the problem, explanatory models, goals, and finding interventional means; (3) social comparison, cognitive undoing, metaphors, shared experiences and relaxation techniques; (4) working through the trauma, testimony approach; (5) ritualistic, cognitive and supportive approaches; (6) principle of education and advice; (7) evaluating and revizing treatment and stabilizi...

An audit of a school-based counselling provision for emotional and behavioural difficulties in primary school children

Abstract: The presence and prevalence of mental health problems in young children ad well as therapeutic interventions is less well understood than the same problems in adults, Long-term consequences of childhood mental health problems have been noted, yet provision of services at the age appropriate level is ofter limited. This sudy presents a case note audit of 540 children attending an innovative programme for counselling and therapy in school-based centres based in 8 inner London Primary schools. This represented 22.4% of all children attending the schools, with an overage age at referral of 8.1 Years. 53.8% of boys compared to 46.2% girls ew referred emanating from varied backgrounds. The majority of the children spoke English at home (86%) and the only significant differences according to home language related to concern over social interactions. Comparisons between children cared for by both parents(48%) and those cardd for by a single parent (37.3%) showed the latter group to have higher distress a...

Client or patient? Contrasts between medical and counselling models of confidentiality

Abstract: Conflicts can arise within counseling in primary care settings over issues of client confidentiality as perceived from a therapeutic as opposed to medical perspective. ‘Ideal types’ of counseling confidentiality and medical confidentiality are compared, according to a proposed structural model of confidentiality. In contrast with a therapeutic concept of confidentiality as an interpersonal contract between client and counsellor, a structural model of confidentiality appropriate to medical and primary care settings would include reference to crucial aspects such as risk assessment, and the sharing of client information within a multi-disciplinary team. The client-centred counselling model of confidentiality is then explored with reference to the Derbyshire Inquiry Report on the mental health care provided for a client with psychiatric problems. The limitations of adopting an exclusive client-centred counselling approach towards confidentiality in primary care settings are noted, given the requirem...

Individualism and Psychotherapy: Are psychologists leading or following individualistic trends?

Abstract: There has been much recent concern about the promotion of individualism in psychotherapy. This study assessed wheather psychologists differed in their preference for individualism from univerisy professors and students, in terms of how they view individuals' difficulties. The 289 respondents were presented with six clinical vignettes, and chose one of the four theoretically based perpectives of the person's difficulties. There were two individualisticn responses and two responses emphasizing social embeddedness and responsibility. The results indicated that there were no differences among the predominantly individualistic perpectives of the psychologists, the university professors, and evening school students. The respondents were equally individualistic with socially integrated and socially alienated clients which suggests that an individualistic bias was present in all three Groups.

Brief psychodynamic counselling with young adults

Abstract: Short-term counselling is frequently employed within university counselling services in which there can often be an inherent institutional objective of returning students to the academic treadmill as soon as possible (Coren, 1996). On the other hand, this is perhaps tempered by the availability of counselling throughout the student's academic career, affording them the opportunity to return for further intensive short-term work (or longer-term if indicated or required). However, research into the effectiveness of short-term counselling suggests that interventions of less than eight sessions are as effective as those lasting significantly longer (Barkham, 1989). This may be particularly true in the case of students experiencing transitory problems relating to their life at university. This paper uses a case illustration to examine the value of short-term psychodynamic counselling in a university situation.

The effects of a programme of training in structured group counselling

Abstract: This study examined the effects of a programmes of experiential training in structured group counselling, based on the approach of Sheldon Rose. Participants were 32 undergraduate and graduate students, divided into three groups, who participated in the group work as part of a course in Core Counseling skills. The groups met for two hours per week for eight weeks. At the end of each exercise the participants completed a 12-item questionnaire giving their evalution and experience of the exercise they had just finished. The questionnaires were initially factors analysed and produced three main factg43ors, labelled task orientation, cohesion and conflict. Factor scores were used for all subsequent analyses. A series of one-way analyses of variance showed how the groups reacted to the different exercises, and discriminant analysis was used to determine how the climate and method of the individual groups could be differentially characterised in terms of the questionnaire factors. It was concluded that...