Handbook of Counselling

Gladeana McMahon, Stephen Palmer

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317857983
• Edition: 2
• Topic: Psicología
• Subtopic: Psicoterapia

The Handbook of Counselling provides a comprehensive and up-to-the-minute guide for counsellors and those using counselling skills in other professions. The contributors, all experienced practitioners, explore the major arenas and settings in which counselling is practised as well as the key themes and issues faced by those working in this field.
This edition of the handbook has been thoroughly revised and updated to reflect the pace of growth and change within counselling over recent years. Six new chapters have been added, covering:
* brief and time-limited counselling
* working with adults abused as children
* trauma and post-traumatic stress disorder
* counsellor-client exploitation
* private practice
* counselling in voluntary settings.
Published in association with the British Association for Counselling, the Handbook of Counselling provides a definitive source of information and guidance for counsellors both in training and practice.

Part one
Introduction

Chapter one
Counselling in Britain: present position and future prospects

Ray Woolfe

Introduction

The aim of this chapter is to provide an account of the nature and range of counselling as it is practised in Britain in the mid 1990s. This process will encompass discussion of the major issues facing counselling at the present time. In particular, the chapter aims to:

• (1) offer a definition of counselling and discuss its universality;
• (2) examine the extent to which it is legitimate to regard counselling as a homogeneous, unitary activity;
• (3) comment upon the major counselling paradigms;
• (4) explore the boundary between counselling and related disciplines;
• (5) identify the settings in which counselling is practised, the counsellors and their clients;
• (6) outline and discuss key issues within counselling at the present time;
• (7) articulate the role played by the British Association for Counselling.

Defining counselling

Counselling is still a relatively new activity. The British Association for Counselling, now widely recognized as the voice of counselling in Britain, came into being as recently as 1977 having metamorphosized out of a Standing Conference for the Advancement of Counselling. This in its turn had been created in 1970 through the auspices of the National Council for Voluntary Organisations.

In the intervening years, counselling has come a long way, yet there is still no copyright or patent on the use of the term. In common parlance, it is frequently understood as a form of advice giving and this is legitimized by the continuing practice of dictionaries, one of which defines counselling as 'specifically a therapeutic procedure in which a usually trained person adopts a supportive non-judgemental role ... or gives advice on practical problems' (Brown 1993). The term is now widely employed in this manner. For example, in the area of business and finance, one comes across references to such activities as debt counselling and double-glazing counselling.

Perhaps this is not surprising and, in a slightly odd way, a compliment to the influence of counselling. At root, counselling is based upon communication, listening and interpersonal skills. These are essential in a wide range of interpersonal situations, not least in helping activities. Many helping activities arise spontaneously as when a friend, relative or colleague suddenly confronts us with a personal problem or stressful issue. These skills then come into play. However, the key difference between events such as these or the approach of the company representative lies in intentionally. Counselling differs from friendship in that its focus is not on the provision of tea and sympathy or on advice giving and it differs from selling in that its aim is not to manipulate another person into making a purchase.

In contrast, counselling is an activity engaged in deliberately, with a clear intention and operating according to a clearly defined set of rules.

People become engaged in counselling when a person, occupying regularly or temporarily the role of counsellor, offers or agrees explicitly to offer time, attention and respect to another person or persons temporarily in the role of client.

(BAC 1985: 1).

The use of the term 'explicitly' is, according to the same document, 'the dividing line between the counselling task and ad hoc counselling and is the major safeguard of the rights of the consumer' (BAC 1985: 2).

This definition of counselling provides a framework or reference point around which further discussion about the state of counselling in Britain can take place. Counselling requires rigorous definitions if it is to avoid the danger of becoming vague and diffuse. It is particularly necessary given the existence of an accreditation scheme for counsellors within BAC and even more importantly in light of the existence of the United Kingdom Register for Counsellors.

Having made this point, it is also neccessary to indicate that the use of precise definitions and the development of professional boundaries raises a number of important issues with which counselling generally and BAC in particular will continue to wrestle. These derive primarily from the fact that the activity of counselling is not confined to the work carried out by those people formally designated as counsellors. This is reflected in the title of BAC: an organization for counselling and not just for counsellors. Many people, paid and voluntary, with a vast variety of titles and forms of professional identification would claim to be practising counselling in the course of their work, though their primary identification might well not be 'counsellor'. Some of them have had considerable counselling training. Without their contribution, counselling would be a very restricted and exclusive activity.

In practice, the distinction between the activity known as counselling and the practice of counselling skills within another form of contract may not always be easy to draw. This may particularly be the case in situations where counsellor and client hold other roles in relation to each other. For example, a manager may have the task of acting as counsellor to a worker for whom s/he has line management responsibility; or a tutor may counsel a student with whom s/he has a teaching role. The BAC definition attempts to resolve such conflict by emphasising that 'clarification of the opportunity offered, in a way that the client can understand, differentiates the counselling task from other mutual responsibilities in the perception of both client and counsellor' (BAC 1985: 2). However, the tidiness of such theoretical definitions may not always be easy to replicate in the complex and often confusing empirical world in which we live.

Professional boundaries

The previous discussion addresses the need to distinguish between situations in which there is a clear counselling contract as opposed to those in which counselling skills are practised without such a contract. In short, this represents a boundary issue concerning what is and what is not counselling. However, there is another key boundary issue for counselling concerning its relationship to cognate professional disciplines, particularly psychotherapy and counselling psychology. In considering this topic, it is appropriate to remember that while historically there are clear differences, operationally the differences have become muddled (Carroll 1991).

Counselling and psychotherapy

There is long running debate about the difference between counselling and psychotherapy. There are those such as Patterson (1974) who conclude that there are no essential differences and Truax and Carkhuff (1967) use the terms interchangeably. However, the following points are often made in attempts to differentiate between the two processes. They do not necessarily represent the views of the author of this chapter. Inevitably, there is some overlap between the individual views.

• (a) Psychotherapy is concerned with personality change whereas counselling is concerned with helping an individual to utilize his or her own coping resources (Tyler 1967). Clarkson (1994) suggests that psychotherapy can be seen to emphasize intervention, treatment and reconstruction whereas counselling has an enabling and facilitating focus. However, Nelson-Jones (1982) argues that mobilizing coping resources might well be considered as personality change.
• (b) Psychotherapists work with people who have histories of pathology and psychological disturbance. In contrast counselling involves a process of problem solving with people who are basically emotionally healthy but who are being confronted by a temporary life problem or issue, related to a crisis or developmental stage.
• (c) The focus of work for many psychotherapists is the transference between the two parties and the unconscious world of the client; the past life of the client re-experienced in the present. In contrast, counsellors work in a person-centred manner with the here and now relationship between therapist and client as the lynchpin.
• (d) Psychotherapy is a long-term process, whereas counselling essentially has a short-term focus.
• (e) Psychotherapy training is based upon personal analysis combined with the development of diagnostic and analytical skills. In comparison, counselling training is concerned less centrally with personal analysis and more with the process of goal setting and the tasks involved in achieving these. This view of counselling would be supported by the emphasis placed in counselling training over the past fifteen years on the work of Gerard Egan.
• (f) Psychotherapy practice is rooted in psychodynamic theory, whereas the theory underpinning counselling is largely derived from and inspired by humanistic writers such as Carl Rogers.
• (g) Psychotherapists work largely in clinical and medical settings, while counsellors work across a wider range of arenas, including educational institutions and the workplace. It follows that psychotherapists tend to refer to patients, while counsellors talk about their clients. On the other hand, an increasing number of counsellors have found employment within the primary health care setting.

There can be no final answer to the question of whether counselling and psychotherapy are one and the same thing. In examining the difference, Clarkson (1994) lays emphasis upon the focus of psychotherapy being what she describes as 'revolutionary change' as opposed to the 'evolutionary change' which is the concern of counselling. She sees each as emphasizing different skills, goals and methodologies. However, rather than debating the validity or otherwise of this point of view, it seems more constructive to emphasize personal identity and to reflect that in the world in which we live, some people identify themselves as counsellors, others as psychotherapists and some as both. For example the United Kingdom Council for Psychotherapy, which was founded in 1993 contains eight sections:

• Psychoanalytic and Psychodynamic Psychotherapy
• Behavioural Psychotherapy
• Family, Marital, and Sexual Therapy
• Humanistic and Integrative Psychotherapy
• Hypnotherapy
• Analytical Psychology
• Psychoanalytically Based Therapy with children
• Experiential Constructivist Therapies

It does not seem fanciful to suggest that members of the behavioural section for example might have more in common with cognitive-behavioural counsellors than they do with members of many of the other sections. The same could be said about almost every section. Personal identity is arguably more important than a theoretical debate over whether we are referring to the same or different activities. In the final resort, attempts to resolve the issue in terms of some overarching theoretical plan are probably futile. There are some differences, as Clarkson indicates, but both enterprises lay stress upon valuing the client as an individual, listening in an accepting and non-judgemental fashion and fostering the capacity for self-help. In practice as opposed to theory, such differences as do exist often lie in relatively mundane concerns with the nature and length of training, the settings in which people work and the problems and issues with which they are typically confronted.

Counselling and counselling psychology

Counselling psychology is a relative newcomer to the therapeutic scene, but one whose relationship with counselling is interesting to explore, particularly as it throws light upon some of the strengths and weaknesses of counselling in Britain at the present time. The historical development of counselling psychology in Britain since its first appearance in 1982 as a section within the British Psychological Society has been charted by Woolfe (1990 and 1996). He has identified a number of key factors underlying this development and its rapidity. These include:

• an increasing awareness among psychologists of the importance of the helping relationship as a significant variable in working with people;
• a growing questioning of the medical model of working with people across a wide range of helping professionals and corresponding acceptance of a more humanistic value system;
• an increasing emphasis in the work of helpers on promoting well-being rather than responding to sickness and pathology;
• a developing awareness of the need for a more articulated scientific basis for counselling.

Consideration of these factors illustrates both the strengths and the weaknesses of counselling in Britain (as well as the underlying strengths and weaknesses of psychology). On the one hand we can observe the strong roots of counselling in a humanistic value system and the increasing acceptance of this value system. On the other hand we can note its traditional lack of rigour in its approach to evaluating its own practices. (Barkham and Barker 1996, McLeod 1995, Elton Wilson and Barkham 1994). Evaluation is all too often still of the intuitive, hunch variety.

The underlying dynamic behind the growth of counselling psychology lies in a perceived need to bridge this gap, to understand counselling as both a science and an art. This has involved the development of a more interactive, process based, qualitative research methodology; see for example Toukmanian and Rennie (1992), McLeod (1994) and Barker et al. (1994). The development of research methods courses within Masters programmes in counselling is a reflection of this dynamic.

Counselling psychologists are first and foremost psychology graduates and underlying their practice is an emphasis upon the systematic application of psychological knowledge founded in a base of empirical research. It is argued, with some justification, that this knowledge base and understanding of research methodology is not accessible without a psychology degree.

It is appropriate to point out at this point that counselling psychology has its own boundary issues particularly concerning clinical psychology. Indeed, as some clinical psychology services now offer counselling to purchasers such as primary health care practices, there would appear to be points at which counselling and clinical psychology overlap. The overlapping of professional boundaries certainly does not end here. Many community psychiatric nurses provide counselling services and the list could be extended to include social workers, probation officers, occupational therapists, speech therapists and psychiatrists. This list is not exhaustive.

As with psychotherapy, the boundaries between counselling and counselling psychology are blurred and inexact. However, there seems no purpose in arguing whether these boundaries should or should not exist. The fact is that they are there and their existence is due to historical circumstances which cannot be changed. There are now over 250 chartered counselling psychologists listed in the Register of Chartered Psychologists held by the BPS. Therefore this group would appear to be a significant force in counselling practice in Britain at the present time.

Different traditions within counselling

What emerges from the previous discussion is that in examining the relationship between counselling and cognate disciplines, it is important to acknowledge their origins in different cultures, traditions and bodies of knowledge. However, even if we leave aside psychotherapy and counselling psychology, contemporary practice within counselling itself is anything but homogeneous and, on the contrary, manifests enormous diversity.

Dryden's handbook of individual therapies in Britain (1990) contains accounts of twelve major theoretical approaches:

• Psychodynamic (Freudian)
• Psychodynamic (Kleinian)
• Psychodynamic (Jungian)
• Adlerian
• Person-Centred
• Personal-Construct
• Existential
• Gestalt
• Transactional Analysis
• Cognitive
• Behaviour

Within this list, at least three major traditions are represented and each has influenced con...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• Figures
• List of Contributors
• Preface
• Abbreviations
• one Introduction
• two Arenas
• three Settings
• four Themes
• five Issues
• Appendix 1 The British Association for Counselling's Code of Ethics and Practice for Counsellors
• Appendix 2 The British Association for Counselling's Code of Ethics and Practice for Counselling Skills
• Appendix 3 British Association for Counselling's Code of Ethics and Practice for Supervisors of Counsellors
• Appendix 4 The British Association for Counselling's Code of Ethics and Practice for Trainers in Counselling and Counselling Skills
• Appendix 5 The British Association for Counselling's Ethical Guidelines for Monitoring, Evaluation and Research in Counselling
• Author index
• Subject index