bluuebunny/crossref_metadata_2025 huggingface dataset:
Ideal and Actual Referral Choices for Mental Health Problems in Primary Care
Authors: Dolley Tania , Adams Bryan , Hampton James
Published: January 2023

With the increasing role of primary care in managing mental health problems there are now a number of different professionals who may deliver this service. GPs in one county were surveyed to find out which professionals they currently refer patients to with particular psychological problems, and which they would perceive to be the ideal referral choice if available. Results identified GPs’ perceptions of ideal professionals to treat each problem, their degree of consensus on this and discrepancies between ideal and actual referral choices.

Overall, at least half the GPs could refer to their perceived ideal practitioner. There was greater discrepancy between actual and ideal referral choices for several problems, where 30 per cent to 50 per cent of patients were not currently being referred to the ideal choice. This may indicate shortfalls in service provision, for various practitioners, and raises questions about the effectiveness of treatment available to these patients. GPs often see patients themselves instead, or refer elsewhere, especially to CPNs who are readily available.

Consensus was high for some problems, and for others was spread between four or five different practitioners. Questions arise about appropriateness of some referral choices and practitioner qualifications. The need for clearer information and referral guidelines is highlighted, and perhaps a reassessment of priorities in service provision.

The case for referral guidelines has been made by ‘Treatment Choice in Psychological Therapies and Counselling – evidence-based clinical practice guideline’, Department of Health, February 2001. (www.doh.gov.uk/mentalhealth/treatmentguideline).

This study reinforces this need for clear referral guidelines.
The Call of the Wild: Lessons from Natural History
Authors: Milton Martin
Published: January 2023

It will be evident to counselling psychologists that evolutionary psychology seems to be commanding attention recently (see The Psychologist, 14 (8)). This literature argues that therapeutic psychology gains valuable insights by locating emotion, consciousness, meaning and the like in an evolutionary context (Bailey & Wood, 1998; DelMonte, 2001; Gilbert, 1998a; Silverstein, 1998). It is also argued that it may be helpful to recognise that some of our evolved talents and abilities have not had the chance to ‘catch up’ with cultural change (de Waal, 2001; Dixon, 1998; Gilbert, 1998b). This paper is related to this literature to the extent to which some people remain attuned to our proposed origins, i.e. living in the wild.
Beyond the looking glass: The qualitative research process as a development of self
Authors: Bartlett Sarah
Published: January 2023

This paper offers a subjective account of the research process and considers the impact of undertaking a qualitative research study on the author. It demonstrates the reciprocal element of reflexive research, both acknowledging the values brought to the research and recognising that the examination of the process shaped the author’s experience, personally and as a psychologist.

The place of reflexivity is also discussed and how this fits in to the model of counselling psychology. The values of feminist psychology and those of counselling psychology inform the argument. The centrality of a subjective voice and a reflexive examination of that voice are seen as essential in acknowledging the assumptions within a research study.
Book Reviews
Authors: Goff Ashley , Moon Lynsey
Published: January 2023

Reviews ofCounselling Children – A Practical Introduction (2nded.)by Kathryn Geldard & David Geldard andHandbook of Affirmative Psychotherapy with Lesbians and Gay Menby Kathleen Y. Ritter and Anthony I. Terndrup
First Response– ‘Storm and Stress’: The experience of learning evidence-based practice
Authors: Monk Patricia
Published: January 2023

Patricia Monk, a recent graduate of the Surrey course, was asked to give voice to the experience of learning about, and how to ‘do’ evidence-based practice.
The dialogic unconscious: The missing link or a contradiction in terms?
Authors: Diamond Debora , Milton Martin
Published: January 2023

For many years the author Jenny Diski suffered from depression, having several episodes of in-patient care and sampling many of the various types of therapy on offer, both privately and within the NHS. Her lament, centring around the notion of choice, echoes that of many clients who express distress or frustration at feeling hemmed into particular ways of being either by developmental process or biological determinants or sometimes by limited social opportunity. The above quote acts as a starting point for this paper because we do not intend to claim that the approach upon which the theoretical stance is based, and which supports the first author’s clinical work, is a conclusive end product of study or that it in any way reflects an ‘answer’ to the struggles faced in therapeutic encounters. Rather, it provides a fluid, adaptive framework for the investigation of the client’s distress, their needs and their preferred lifestyles and choices and it addresses individual and interpersonal dimensions of life. In that sense, the notion of the ‘dialogic unconscious’ provides a lens through which attempts to focus attention on the client’s lived experience at all of these levels can be made.
Book Reviews
Authors: Gilbert Kendra , Goff Ashley
Published: January 2023

Reviews ofThe Therapist’s Use of Self; Core Concepts in Therapyby John Rowan and Michael Jacobs, andWorking with Interpreters in Mental Healthedited by Rachel Tribe and Hitesh Ravel.
The experience of silence: A client case study
Authors: Harris Angela
Published: January 2023

This case study was written as a personal way to bridge the gap between written accounts of person-centred therapy and my experience of working with one client. The literature that I have studied uses illustrations of dialogue between therapist and client to demonstrate empathic understanding and I am sometimes left with the impression that the therapist is constantly chattering. This could be one of the limitations of written media as opposed to video or audiotape. It occurred to me that the nature of case studies means that silence – particularly long silences – could be excluded. I think I would have to be very brave to submit a transcript where I, as therapist, said almost nothing for a 10 minutes section analysed in depth, even though the intervention was pivotal to the therapeutic process. This insight led me to read some of the literature on silence and I was very surprised to find so little written by person-centred practitioners. Reflective responses seem to be the dominant discourse within person-centred therapy publications. It is possible that this discourse is distorting person-centred therapy away from non-verbal interventions and silence. This made me think about whether I talk too much with my clients and has altered my practice. Using silence as the core topic helped me get an edge or perspective when writing the case study and this made it more interesting to write.

The acts of reviewing the case and writing the case study helped me to revisit person-centred counselling. I think I had rather taken the core conditions for granted. Writing the case study was a good discipline to help me understand when I veered from them to pursue my own track rather than follow the client’s. It was such hard work to do and demanded a very high level of concentration and listening skills.

I enjoyed thinking about the case, because I felt warm feelings towards my client, ‘Sam’. I judged my work to be successful and this helped me be less defensive about mistakes I had made. It was hard to sieve out the less important information to fit the word count requirements, such as why his wife was angry. However, this was a helpful process in itself because it forced me to distil all the thoughts and memories into a coherent form and to look at themes rather than data.
The therapeutic relationship in cognitive-behavioural therapy
Authors: Giovazolias Theodoros
Published: January 2023

Cognitive-behavioural therapy derives from a tradition that has been known for emphasising techniques for which the therapeutic relationship was almost a neglected aspect and was considered to be a non-specific factor. However, it has become increasingly apparent within the field of cognitive-behavioural therapy, that focusing on just the technical aspects of the therapeutic process implied a self-imposed limitation of the heuristic value of the theoretical model (Schaap et al., 1993). It was thus recognised that behaviour can be influenced by interpersonal factors as well as techniques and gradually researchers as well as practitioners within this model have begun to ascribe greater significance to the therapeutic relationship in order to understand better the therapeutic process itself.

This article will aim to address the issues mentioned above and provide an opportunity for a better understanding of the conceptualisation of the therapeutic relationship as well as its interplay with the implementation of the technical aspects, within the specific context of cognitive-behavioural therapy.
When ‘Perfect’ clients receive ‘Imperfect’ therapy: A cognitive approach to working with perfectionism
Authors: Corrie Sarah
Published: January 2023

It was Somerset Maugham (1963) who said the problem with perfection is that it is apt to be dull. However, the cost to those who subscribe to the standards that perfection demands is considerably greater than dullness.

Perfectionism has been associated with reduced emotional well-being and decreased quality of life. More specifically, it has been implicated in a wide range of mental health problems. In addition to depression and suicidality, anxiety and eating disorders (see Corrie, 2002, for a review), perfectionism has been identified as a central component of obsessive-compulsive and borderline personality disorders (American Psychiatric Association, 1994; Layden, Newman, Freeman & Morse, 1993). As Ferguson and Rodway (1994) suggest, the literature increasingly points to the fact that perfectionism is a problem in its own right rather than an epiphenomenon of other disorders. There is, however, a dearth of guidelines on how to work therapeutically with perfectionism.

This paper has evolved out of my own attempts to support clients whose personal standards have contributed to high levels of distress. In a previous paper (Corrie, 2002), I outlined a series of questions that could act as useful prompts to aid therapeutic exploration in this area. In this paper, I develop these ideas further by outlining a cognitive therapy approach to working with perfectionism. By presenting this approach in the context of a case study, I aim to provide a framework for understanding and working with perfectionism that might prove helpful for practitioners supporting clients with similar difficulties.
Three years of counselling psychology in an Intensive Care Department
Authors: Hazzard Anthony , Henderson Beverley
Published: January 2023

The discipline of counselling psychology is relatively young in comparison with the venerable traditions of medicine and nursing, but from the outset counselling psychologists have found themselves working in medical settings and in close co-operation with nurses and medical practitioners.

The specialties of primary care, mental health and palliative care were early and obvious partners for counselling psychologists but it has taken far longer for more technical specialisms to perceive the benefits of a psychological presence.

A close look at any medical setting or health care activity however is likely to reveal a wealth of psychological implications.
Divisional News
Authors: James Pam
Published: January 2023

Paper given at the 10th Annual Conference of the Division of Counselling Psychology: 15 May 2004 at the Royal College of Obstetrics and Gynaecology, Sussex Place, London.
Embracing psychometric assessment: Enhancing a cognitivebehavioural eating disorders practice through the qualitative use of self-report measures
Authors: Raspin Courtney G. , Kanellakis Pavlo
Published: January 2023

This paper is an effort to briefly outline how we strive to translate the philosophy of counselling psychology into the use of self-report measures. In doing so, we hope to model how self-report questionnaires designed primarily for outcome can be used qualitatively, thus providing not only valuable outcome data, but also an indispensable opportunity to develop the therapeutic relationship, better plan treatment, and harness the subjective experience of our clients.
The use of psychological tests and measurements by psychologists in the role of a counsellor in Greece
Authors: Triliva Sofia , Stalikas Anastassios
Published: January 2023

The purpose of this article is to present the results of the survey we have conducted on the use of psycho-logical tests, assessments and measurements in Greek psychologists in the role of a counsellor. The questions we have addressed are: (1) Which tests and measurements are used? (2) How useful do professionals consider these tests? And, (3) what are the reasons for using these instruments? The findings of the survey are discussed within the context of the cultural conditions – both ‘internal and external’ – to psychology as a discipline that impact upon the use of psychological measurements.
Book Reviews
Authors: Smith Andrew J. , Lewis Rachel
Published: January 2023

Reviews ofHandbook of Solution Focused Therapy, edited by Bill O’Connell and Stephen Palmer, andCounselling Adolescents: The Pro-Active Approachby Kathryn and David Geldard.
Using psychometrics in an NHS addictions service
Authors: Ploszajski Jo
Published: January 2023

I was pleased to see that the editor has chosen to dedicate an edition ofCounselling Psychology Reviewto the use of psycho-metric testing, as I believe that our growing knowledge of the workings of the brain at the neuropsychological level means that Counselling Psychologists need to take into account any structural and functional neuropsychological limitations patients may have when we formulate their problems and develop treatment plans. Sometimes, as I shall show below, psychometric methods seem to be the most efficient way of assessing structural and functional deficits (or indeed strengths) and yet little published information seems to be available to guide the non-specialist psychologist with limited NHS resources. I will aim, therefore, in this essay, to provide an outline of my rationale for using psychometric tests as part of my role as a Counselling Psychologist, indicate some of the practical issues I have encountered, and give two examples of how I have used testing in the course of assessing patients with suspected alcohol induced dementia and suspected attention deficit disorder.
Some thoughts on counselling psychology and the therapeutic use of texts in clinical practice
Authors: du Plock Simon
Published: January 2023

This paper offers thought-provoking reflections on the role of books in the promotion of psychological well-being. It reflects on the importance of such literature, but also draws our attention to the need to clarify ways of understanding how clients themselves produce narratives, and how they can be facilitated in a process of ‘re-storying’ themselves.
The Islamic Concept of the Self
Authors: Inayat Qulsoom
Published: January 2023

Counselling psychology operates within a multicultural context. This requires that counselling psychologists take steps to increase their multicultural competencies. One aspect of such competencies refers to the knowledge base of counselling psychologists in terms of different black and ethnic minority groups. Such an endeavour could serve to redress the underutilisation of services by black and ethnic minority groups. This paper seeks to invite counselling psychologists to become more aware of the world view of Muslim clients. This is important in light of the guilt felt by Muslim clients after the September 11th bombings in America. Muslim clients are also persecuted as a result of this event and their feelings and fears need to be validated if counselling psychologists are to empower and enable such clients in their journeys. In an effort to clarify the world view of Muslim clients I have explored the differences between Western and Islamic psychology. I have also described the Islamic model of the Self. This information could facilitate therapists’ interventions so that Muslim clients can feel that their religion and spirituality are an acceptable part of the therapy process.
Attachment and representational change in cognitive analytic therapy: Developing a taxonomy
Authors: Sochos Antigonos
Published: January 2023

A number of studies suggest that the couple relationship is a crucial aspect of the individual’s supportive network, playing an important role in the maintenance of mental health and the recovery from psychological disorder. The aim of this study was to investigate how Cognitive Analytic Therapy may change the patients’ understandings of their couple relationships and, possibly, the relationships themselves. Eleven outpatients presenting mostly with neurotic and personality disorders were interviewed before and after treatment about their current couple relationships, while clinical improvement was also assessed on a number of scales. A qualitative analysis was conducted on the patients’ accounts, revealing that the patients experienced their interpersonal space as being defined by three dichotomies: self vs. other, autonomy vs. relatedness, and dependent vs. depended-on positions. Moreover, the patients’ perception of autonomy tended to change in reference to the dependent position, while that of relatedness did so in reference to the depended-on. In addition, post-therapy changes regarding autonomy were asymmetrical, with the self being presented as strengthened and the other as relatively weakened; in contrast, changes regarding relatedness were symmetrical, presenting both partners either as more, or as less emotionally available. On the basis of differences in change, three types of patients were identified. As the findings were considered within the framework of attachment theory three research questions were formulated for further investigation: (a) the patients’ subjective experience may have revealed information about their deeper attachment representations; (b) changes in that experience may have suggested shifts in the patients’ security of attachment; and (c) different types of change in that experience may have suggested diverse pathways through which shifts in attachment security may have been attained.
Letters to the Editor
Authors: Giddings David , Jenni  , Hart Nicky , Reddy Michel , Milton Martin
Published: January 2023

Counselling Psychology Reviewsupports freedom of expression and welcomes controversial correspondence, thoughtful comments and lively contribution to public debate. ‘Letters to the Editor’ provides a forum for readers to: (1) debate issues pertaining to counselling psychology; and (2) extend the peer review process with comment on earlier published papers. Where a letter refers to a previous publication, the original author will be offered the right of reply.
An extraordinary day
Authors: Hayward Mark , Green Ruth , Meddings Sara
Published: January 2023

This article will utilise multiple perspectives to describe the process of several hundred people meeting to explore the possible ordinariness of the experience of hearing voices.
Chair’s Notes
Authors: Goldstein Ralph
Published: January 2023

Ralph gave this address at the AGM.
A week in the life of a Counselling Psychologist in a CAMHS context
Authors: Georgopoulou Victoria
Published: January 2023

Part of a special edition on the everyday working lives of counselling psychologists.
My rôle as a Consultant Counselling Psychologist within the NHS
Authors: Walsh Yvonne
Published: January 2023

Part of a special edition on the everyday working lives of counselling psychologists.
Trainee Counselling Psychologist Prize: Joint runner-up What constitutes change?
Authors: Taylor Morag Anne
Published: January 2023

Facilitating beneficial change is the main thrust of therapy. Possible factors contributing to change are illustrated in work with a client using the model of brief psychodynamic therapy. Precursors to change, such as engagement in pre-therapy and working alliances, are discussed. The point of change seemed to be instigated through an accurate, empathic interpretation. The implications of this sensitive and appropriately timed understanding of a core issue in the client, which sparked release of emotional distress and subsequently aided insight and change in her behaviour, are critically evaluated. Consideration is also given to the relevance of the context and setting within which this change occurred. Differences in perception of change between client and trainee counselling psychologist are noted. Alternative hypotheses for the series of changes are explored and reflections given on my learning.
Working with those affected by the ‘Troubles’ in Northern Ireland; risk factors and vulnerability
Authors: Thompson Áine
Published: January 2023

‘Each one of us journeys alone into this world – and each one of us carries a unique world within our hearts. No-one experiences your life as you do; yours is a totally unique story of experiences and feelings.’

(O’Donohue, 1997).
There is nowhere to hide
Authors: Batmanghelidijh Camilla
Published: January 2023

Conference – Keynote paper
Psychoanalytic reflections on suffering, loss, and life that leads to death
Authors: Vella Maria
Published: January 2023

An ongoing life challenge for human beings is to face suffering, various sorts of loss, and life itself, that ultimately leads to death. This paper is an attempt to reflect on these existential givens from a psychoanalytic perspective.

I will begin this paper by sharing a personal experience about my observing myself getting older, both on an ontic and ontological level. I also reflect on how the people around me react painfully and squirm on coming face-to-face with this natural life process. This reaction in turn, leads me to investigate how psychoanalytic contributors, not least, the founder, Sigmund Freud, together with modern contributors like Adam Phillips and Matthew von Unwerth, perceive and interpret beauty, joy, and life in relation to loss and transience. Under Phillip’s influence I again ask two fundamental, recurring questions, namely: ‘Is there the right amount of suffering in the world?’ And, ‘Does life ask more of us than we can bear?’

In this paper, I am focussing exclusively on how we tend to perceive beauty and joy as tarnished and destroyed by transience, loss and death. Moreover, I will focus on our difficulty to endure the constant tensions and conflicts that life bestows on us, especially with regard to the process of mourning. More specifically, I will draw on my experience as a counselling psychologist in training, my work with a particular client, and the affects this triggers in me. I conclude this essay by quoting Phillips’ contention about the uncanny paradox of suffering.
Talking Point: The Lonely Planet Guide to trainee setbacks on the road to qualification
Authors: Benamor Zara
Published: January 2023

An extract from a trainee’s personal journal (2006–2007). It is written as a journal entry for Year Two Personal and Professional Development Log (PPD log) towards the Doctorate of Counselling Psychology. CBT (Beck, 1980) is used as the framework for reflection. This is only one trainee’s personal experience, but it may help other trainee practitioners with similar setbacks on the road to qualification.
A review of the experience and explanation of psychological change
Authors: Gianakis Mary , Carey Timothy A.
Published: January 2023

Facilitating favourable change in the experience of psychological distress is the remit of psychotherapy. Yet many people who change psychological distress do not receive psychotherapy. In order to maximise the effectiveness of psychotherapy it is argued that it should first be necessary to understand the change process. In this paper, the importance of the perspective of the individual undergoing change is highlighted. Then, selected models of change are outlined and compared and contrasted. Finally, qualitative research investigating the change experience is reviewed. Although quite a lot of research has been conducted regarding change within psychotherapy, there is a paucity of research exploring how people change without the assistance of psychotherapy. It is concluded that research investigating the experiences of people who change without psychotherapy is needed so that a generic model of change can be developed. Once change in a generic sense is understood the core business of psychotherapy may become clearer.
Knowing the brain, unknowing the body
Authors: Rumble Benjamin
Published: January 2023

Increasingly knowledge of right brain function is thought to legitimise therapeutic practices which emphasise that the therapist be experienced as being in a state of affective attunement to the client. In thinking about how neuroscience makes its way into the consulting room the paper considers the idea that while in general neuroscientific and hermeneutical knowledge might combine to form a more complete account of client distress, the specific locus for this epistemological combining will always also be the therapist and his or her relationship to this knowledge. In thinking about the ontological specificity of the therapist, the paper considers the idea that therapeutic knowledge is itself a kind of object relation which the therapist holds in mind within the setting. And in considering the specificity of neuroscience as an object relation, the paper posits that the therapist’s relation to neuroscience is felt right on the body through the introduction of affect attunement based praetioes. Elaborating on this hypothesis the paper considers that a counselling psychological holding in mind of neuroscience might lie in thinking the therapist’s body as a specifically relational presence.
Counselling Psychology training: Implications for ‘Self’
Authors: Lewis Yvette
Published: January 2023

It is widely accepted that Counselling Psychology is underpinned by both Humanist and Post-Modern epistemologies, and that it holds the practitioner’s ‘use of self’ in the service of the therapeutic relationship to be paramount in the therapeutic encounter. Although Humanism and Post-Modernism can both provide theoretical pretexts for the use of self, these stances to knowledge can be experienced as in conflict with each other, and so generate ambiguity and conflict for trainees. The academic (University) contexts of training courses can feed into aspects of these epistemological conflicts in that they uphold individualist-objectivist stances to knowledge/evidence and styles of communication. In this paper psychological literature is drawn upon to explore how trainees are positioned by the discourses of ‘self’ and ‘development’ that are available to them, with particular reference to the discourse of ‘reflective-practice’. The concept of a plural and dialogical self is used to suggest augmenting the manner in which personal and professional development is conducted and assessed.
What do we do about personal development? PD training in Counselling Psychology programmes
Authors: Moller Naomi , Alilovic Katrina , Mundra Neha
Published: January 2023

This investigation comes out of Kat and Naomi’s curiosity, as staff involved in training counselling psychologists, about the various ways that programmes meet the personal development needs of trainees.
Chief Assessor’s Report for the 2008 Assessments for the Society’s Qualification in Counselling Psychology
Authors: Hitchings Paul
Published: January 2023

This annual report is intended to inform the broad membership of the Division of the overall results of the 2008 assessment process for the Society’s ‘Qualification in Counselling Psychology’. It is also hoped that it will provide encouragement to current and potential candidates, supervisors and Co-ordinators of training (COTs).
Refusing to Bow: The diagnostic category of Borderline Personality Disorder considered from an Object Relations viewpoint
Authors: Fletcher Roly
Published: January 2023

As practitioners working within the NHS, the majority of our clients have received a psychiatric diagnostic label, for example, Borderline Personality Disorder. Whilst such labels fit neatly with the current emphasis on time-limited, evidence-based, cost-effective psychological treatments for ‘target’ issues, they tell us little about the client’s particular emotional needs and how the more ‘destructive’ aspects of clients behaviour, particularly towards the practitioner’s attempts to work with them, can actually be understood. This paper outlines the Object Relations approach to Borderline Personality Disorder which is disadvantaged in the NHS due to its typically long-term open-ended nature. This approach focuses on the human condition as a whole and provides the practitioner, regardless of their preferred therapeutic model, with a particularly detailed framework for understanding the client’s inter-personal behaviour and their own emotional responses to such behaviour so that the therapeutic relationship might ultimately allow practitioner and client to feel valued and empowered rather ‘trapped’ by the application of a particular label.
Assessed Unit 4: An academic paper which examines the meaning and implications of anti-discriminatory practice in counselling psychology
Authors: Biggs Stephen
Published: January 2023

You should situate yourself in relation to the issues discussed and the paper should focus on one area of discrimination and be illustrated by specific examples.

Corker (2003) describes counselling as a potentially oppressive process. Given the recent launch of the large scale voluntary sector-led Moving People Programme (MPP) which aims to reduce stigmatisation experienced by people with mental health difficulties (Mind,2007), as well as the fact that the cost of stigmatisation is estimated to be vast (Mason et al., 2001), it seems timely to consider how mental health professionals might be contributing to the process of discrimination. In an attempt to address the marginalisation of people with a diagnosis of personality disorder, the Department of Health issued two specific documents in 2003: ‘Personality disorder: No longer a diagnosis of exclusion’, and ‘The personality disorder capabilities framework – Breaking the cycle of rejection’. The former has meant increased numbers of people with personality disorder being seen within mental health services while the latter acknowledges that better understanding of personality disorder is required in order to interrupt the cycle of rejection often experienced by people with personality disorders due to negative attitudes and practices within agencies. My experience of working in the NHS is that the single most vilified population of service users are those with a diagnosis of Borderline Personality Disorder (BPD). This paper aims to consider how and why discrimination towards people with a diagnosis of BPD is so endemic and argues for the importance of the central humanist orientation of counselling psychology in ameliorating stigmatisation in practice. The paper concludes with some research implications and suggestions for potential ways forward.
Assessed Unit 6: An academic paper which critically examines the philosophical bases of counselling psychology and addresses in particular the relationship between its values and commitment to psychological enquiry
Authors: Martinelli Mabel
Published: January 2023

This paper was written as part fulfilment of the qualification in Counselling Psychology (independent route), AU6 – Philosophical Paper. The paper attempts to critically examine the philosophical bases of counselling psychology, drawing from the historical development of Counselling Psychology as a profession and reflecting on the experience of the author in her personal development to become a counselling psychologist. The paper attempts to integrate concepts of philosophy and values with themes of identity, coherence and commitment, whilst considering key elements to the development of the profession, such as its stance in relation to the medical model, humanistic principles and the scientist-practitioner role.
‘There is a battle within yourself’ Exploring the experience of a split sense of self among inpatients with eating disorders
Authors: Spivack Anna , Willig Carla
Published: January 2023

Aims

This study is concerned with the subjective experiences of people with eating disorders in a specialist inpatient clinic. It seeks to gain an insight into what it feels like to be an inpatient in an eating disorders clinic, observing overall aspects of the experience as well as both challenging and helpful aspects of inpatient life and treatment.

Method

Eight female inpatients with eating disorders, aged 12 to 17, were interviewed. All participants were current inpatients at an eating disorders clinic in a large city in England, and were nearing the end of their treatment. Participants’ narratives of their experiences were analysed qualitatively, using interpretative phenomenological analysis to identify common themes in the interviews.

Findings

The main theme emerging from interviews was the participants’ split sense of self. Participants experienced the presence of both an Anorectic self and a non-Anorectic self. The stronger the Anorectic self, the more negative the inpatient experience, and vice versa. When the Anorectic and non-Anorectic selves were equally powerful, participants experienced strong ambivalence about the inpatient experience.

Implications for Practice

In the light of these observations, we propose that therapeutic interventions may benefit from attempting to facilitate an integration of the two senses of self, rather than reinforcing their opposition by cultivating only the non-Anorectic self and supporting its battle against the Anorectic self.
A preliminary exploration into the prevalence of Early Maladaptive Schemas in a group of people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Authors: Stalmeisters Dzintra , Brannigan Chris
Published: January 2023

Background

Research into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and the impact that Cognitive Behavioural Therapy (CBT) is having on this disabling illness is increasing. However, although schemas have been associated with ME/CFS, research into this relationship does not appear evident.

Aims

The aim of this study was to investigate the prevalence of schemas as described by Young, Klosko and Weishaar (2003), namely Early Maladaptive Schemas (EMS) in people with ME/CFS.

Method

40 people with ME/CFS and 40 people from a non-clinical population completed Young’s Schema Questionnaire (YSQ-S3).

Results

Both mean and frequency scores were analysed. The t-test indicated that the schema social isolation was significantly prevalent in the ME/CFS population, however, few people experienced this as an early maladaptive schema. Frequency scores which identified percentages at a ‘therapeutically’ significant level revealed that the schemas, Unrelenting Standards (URS) and Self-Sacrifice were dominant in both groups. URS was endorsed by 47.5per cent of the ME/CFS group and by 25 per cent of the non-clinical population. The schema Self-Sacrifice was endorsed by 27.5 per cent of the ME/CFS group and 25 per cent of the nonclinical population.

Conclusion

The paper suggests that given the prevalence of the schemas URS and Self-Sacrifice it might be beneficial to assess for these schemas with a view to working with them theraputically. Potentially the schemas may contribute to the perpetuation of ME/CFS affecting the individual’s management and experience of the illness. Additionally, because of the degree of social isolation identified in the ME/CFS group, it is suggested that delivering treatment in groups could go someway to reducing the social isolation experienced by people with this debilitating illness. However, further research in both these areas is necessary.
Is it time we turn towards ‘third wave’ therapies to treat depression in primary care? A review of the theory and evidence with implications for counselling psychologists
Authors: Bhanji Salena
Published: January 2023

Introduction

The current Increasing Access to Psychological Therapies (IAPT) agenda that focuses on the widespread dissemination of CBT in primary care services is considered alongside the emergence of third wave therapies and their role in the treatment of depression.

Review

Theoretical models and empirical outcomes for Mindfulness-based Cognitive Therapy, Metacognitive Therapy, and Acceptance and Commitment Therapy as third wave treatments for depression are examined with implications for how mindfulness approaches can be integrated into the therapeutic work of counselling psychologists (CoPs).

Conclusion

Further theoretical and empirical considerations for the inclusion of third wave therapies into the IAPT agenda are discussed with suggestions for further research.
The therapist’s use of self: A closer look at the processes within congruence
Authors: Omylinska-Thurston Joanna , James Pamela E.
Published: January 2023

Background and research aims

The researcher’s aim was to find out from person-centred practitioners how they process their inner experiences in the therapeutic relationship. From a theoretical standpoint, it meant creating a framework of processes and stages within congruence.

Methodology

Seven person-centred therapists were interviewed with regard to how they processed and used a strong feeling, thought or sensation that they experienced with a client. Data was gathered using semistructured interviews. Grounded Theory Approach was used to analyse the data.

Results

It was found that the therapists processed their internal experiences in the therapeutic relationship through the stages of Receiving, Processing, Expressing and Confirming.

Conclusions

It seems that to be able to use ‘the self’ in the therapeutic relationship counselling psychologists need to be present and tuned-in internally to create conditions for receiving thoughts and feelings from clients. According to the therapists participating in this study who used their internal experiences in therapy, it seemed helpful for clients and a key aspect of the therapeutic process. It did require, however, the therapists to have a high level of self-awareness and internal discipline in order not to ‘act-out’ and misuse power in the therapeutic relationships. These findings indicate the importance of continuous personal development for practising counselling psychologists
How should counselling psychologists investigate their practice in an era of volatility?
Authors: Corrie Sarah , Lane David A.
Published: January 2023

Content and Focus

Counselling psychologists offer their services to clients in organisational, political and economic contexts that are characterised by increasing levels of complexity, uncertainty and turbulence. Investigating the effectiveness of what we do remains critical to the future of the psychology professions, but our traditional approaches to scientific enquiry may not be adequate for the types of dilemma generated by complexity.

Conclusions

This paper describes a framework, adapted from contemporary complexity theory, that can support us in thinking systematically and creatively about the range of investigative skills we might need if professional practice is to prove fit for purpose in the decades to come. It is proposed that complexity theory can assist us in responding creatively to the dilemmas of living and working in unprecedented times.
The identity crisis in trainee counselling psychology research
Authors: Kasket Elaine , Gil-Rodriguez Elena
Published: January 2023

Content and Focus

In 2009, the threshold of registration for counselling psychologists in the UK was set at doctoral level, meaning that henceforth trainees in the field will generally be expected to produce a piece of doctoral - level research in order to qualify. Uncertainties and debates around counselling psychology’s identity, distinctiveness, and contribution have affected research produced by trainees, to the extent that doctoral candidates are often not meeting the doctoral criteria of extending the forefront of the discipline and being at the cutting edge of professional practice, as set out in the Framework for Higher Education in England and Wales.

Conclusions

The authors present a list of traps derived from their experience of supervising and examining doctoral research into which trainees, supervisees and examiners may fall in creating that body of research, and suggest ways of ensuring that trainee research work truly extends the forefront of and contributes to the practice of counselling psychology.
Research methods in Counselling Psychology: What would Wilhelm Wundt think?
Authors: Gil-Rodriguez Elena , Hanley Terry
Published: January 2023

‘Many psychologists… thought by turning their attention to their own consciousness to be able to explain what happened when we were thinking. Or they sought to attain the same end by asking another person a question, by means of which certain processes of thought would be excited, and then by questioning the person about the introspection he had made. It is obvious… that nothing can be discovered in such experiments.’ (Wundt, 1912, p.149)
‘Being kinder to myself’: A prospective comparative study, exploring post-trauma therapy outcome measures, for two groups of clients, receiving either Cognitive Behaviour Therapy or Cognitive Behaviour Therapy and Compassionate Mind Training
Authors: Beaumont Elaine , Galpin Adam , Jenkins Peter
Published: January 2023

Background/Aims/Objectives

This prospective, comparative outcome study was designed to contrast the relative impact of differing therapeutic interventions for trauma victims, carried out by the same therapist.

Methods/Methodology

A non-random convenience sample (N=32) of participants, referred for therapy following a traumatic incident, were randomly assigned to receive up to 12 sessions of either Cognitive Behaviour Therapy (CBT), or CBT coupled with Compassionate Mind Training (CMT). A repeated measures design was used and data was analysed using analysis of variance. Data was gathered pre-therapy and post-therapy, using three self-report questionnaires (Hospital Anxiety and Depression Scale; Impact of Events Scale; the Self-Compassion Scale).

Results/Findings

Results supported two of the three original hypotheses. Participants in both conditions experienced a highly statistically significant reduction in symptoms of anxiety, depression, avoidant behaviour, intrusive thoughts and hyper-arousal symptoms post-therapy. Participants in the combined CBT and CMT condition developed statistically significant higher self-compassion scores post-therapy than the CBT-only group [F(1,30)=4.657, p..05]. There was no significant difference between treatment groups.

Discussion/Conclusions

The results suggest that CMT may be a useful addition to CBT for clients suffering with trauma-related symptoms. In conclusion, high levels of self-compassion are linked to a decrease in anxiety and depression and trauma-related symptoms.
Towards a grounded theory of therapist hope
Authors: O'Hara Denis J. , O'Hara E. Fiona
Published: January 2023

Aim

To identify and explore: (i) how therapists conceptualise hope; and (ii) how they operationalise and work with hope in therapy.

Method and Analysis

Two sets of data were gathered for analysis. The first set came from a short-answer questionnaire completed by 65 trainee and experienced therapists. The second data set was provided by semistructured interviews conducted with 11 therapists. The interview data was transcribed and with the questionnaire data was analysed collectively using grounded theory.

Findings

A large range of findings was produced from the study and is broadly organised into outcomes about the nature and function of hope within therapy and hope-focused strategies. Amongst other important findings, the centrality of the therapeutic relationship in the development of hope was consistently highlighted.

Discussion

The majority of previous research on hope has focused on client hope. While therapist hope has been recognised in the literature for some time, relatively little research has been conducted to explore therapist hope. The findings of the study provide insight into how therapists think about hope and its place in therapy. The paper discusses how therapists engage with hope in therapy and identifies some of the perceived strengths and limitations to working with hope. A range of hope-focused strategies are discussed under the headings of relationship-focused, task-focused and transcendence-focused strategies. Limitations of the study are acknowledged and recommendations for future research are offered.
Counselling for sight loss. Using Hermeneutic Single Case Efficacy Design methods to explore outcome and common factors
Authors: Thurston Mhairi , McLeod John , Thurston Allen
Published: January 2023

Background

Sight loss can lead to depression, suicidal thoughts, social isolation and loneliness. Although there is growing recognition of the need to provide emotional support for people with sight loss, little is known about effective counselling interventions for this client group.

Aims

The aim of this study was to contribute to an understanding of the nature of counselling for sight loss by carrying out a Hermeneutic Single Case Efficacy Design (HSCED) study in which the client was a 70-year-old woman who had experienced sudden and irreversible post-operative sight loss.

Method

The client received six sessions of counselling from a sight-impaired counsellor, working within a pluralistic framework informed by a common factors perspective. The client completed outcome and process measures at each session, and was interviewed at the end of therapy and at follow-up. All counselling sessions were recorded and transcribed. These data formed a rich case record, which was analysed by an inquiry team, using an HSCED procedure. Ethical approval was obtained from the University Research Ethics Committee to conduct this study, and the client engaged in an informed consent process at the beginning and end of her therapy.

Results

Results indicated that the client reported considerable benefit from the counselling she had received. The most important aspects of the therapy process were: feeling understood; being able to express emotions around the loss of sight; finding a new identity; identifying strategies for coping with fear, loss, dependency and other people’s perceptions; exploring the possibility of a future without sight; making sense of things, and finding ways to become more socially connected. These themes are discussed in relation to the development of a model of counselling for sight loss based on a common factors approach.

Implications

The findings of this study suggest that systematic case study research and a common factors perspective have the potential to deepen our understanding of issues presented by specific client groups.