|
|
SOME PRACTICAL DEFINITIONS In simple terms, counselling involves one person (the counsellor) helping another person (the client) to work through some difficult or painful emotional, behavioural or relationship problem or difficulty. That is the form of individual counselling. Dr John McLeod described counselling like this: "Counselling is a wonderful twentieth-century invention. We live in a complex, busy, changing world. In this world, there are many different types of experience that are difficult for people to cope with. Most of the time we get on with life, but sometimes we are stopped in our tracks by an event or situation that we do not, at that moment, have the resources to sort out". If we cannot find ways to sort this out in our family, with our friends, or with a priest or doctor, etc., then "Counselling is a really useful option at these moments". John McLeod, An Introduction to Counselling, 2003. Here is my video description of counselling: A counsellor may also see a couple, especially a married or cohabiting couple, to help them with their relationship. And some counsellors help whole families to work on their relationship problems. See also my Couples Therapy page. Counselling is concerned with a number of different tasks. These can be summarized as follows: "“The term ‘counselling’ includes work with individuals and with relationships, which may be developmental, crisis support, psychotherapeutic, guiding or problem solving … The task of counselling is to give the client an opportunity to explore, discover and clarify ways of living more satisfyingly and resourcefully”. (BAC, 1984, cited in McLeod, 2003). The CENT view of counselling is that, most often, counselling is concerned with "...helping the client to come to terms with past or present reality, and often a very unpleasant reality from the client's past". (Byrne 2011a and 2011b)*. * Byrne (2011a) Appendix M to the CENT e-book on Anger Management; Byrne (2011b) CENT Paper No.15, on Completing your Experience... (See the links on the ABC Newsletter). Counselling takes place in a confidential meeting, in a quiet room, and is subject to a code of ethics which specifies what the counsellor can and cannot morally do in that context. (See the Accreditation and Ethics page). Here is an illustration of a counsellor and client engaging in CBT counselling:
Counselling and psychotherapy come in many forms There are, of course, different approaches to counselling, with some being quite passive, listening forms of counselling; while others are more analytical of the sources of the presenting problem; and others quite philosophical and into teaching the client the philosophical wisdom of the ages. There is now a well researched and documented argument that all systems of counselling and psychotherapy are broadly equivalent in terms of the outcomes they achieve. Ever since Smith and Glass (1977)[1] produced their meta-analysis on the subject, there has been a strong and growing body of research evidence that all systems of counselling and therapy produce broadly equivalent outcomes, and that the outcomes are produced by ‘common factors', such as the nature of the relationship, and the promotion of re-thinking and re-deciding. (Wampold[2] and Messer[3]).[1] Smith, M.L. and Glass, G.V. (1977) Meta-analysis of psychotherapy outcome studies, American Psychologist, 32: 752-760. [2] Wampold, B.E. (2001) The Great Psychotherapy Debate: Model, methods, and findings. Mahwah, NJ: Lawrence Erlbaum. And: Wampold, B.E., Ahn, H., and Coleman, H.K.L. (2001) Medical model as metaphor: Old habits die hard. Journal of Counselling Psychology, 48, 268-273. [3] Messer, S. and Wampold, B. (2002) Let's face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice. 9: 21-25. ______________________________________ Carl Rogers was the father of non-directive counseling, in the USA, where he could not practice more active forms of psychoanalysis or psychotherapy, because he did not have a psychology degree. He therefore created a system which depended upon active listening to help the client to clarify their own issues, and extending three core conditions towards the client: genuineness; empathy and non-possessive caring.
The CBT/REBT approach is probably the most active-directive, and educative, of the counselling approaches. Here is an example of a satisfied client describing her experience of CBT counselling for grief at the loss of her husband.
~~~ If you value the content of this website, and want to show your support and appreciation for our free information and public education role, then please donate to the upkeep of this website:
Thank you for your generosity. ~~~ Impact Therapy, (created by Professor Ed Jacobs at the University of West Virginia, by integrating REBT, TA and Gestalt Therapy), is a highly active form of counselling and therapy. This is how Ed describes the work of the Impact Therapist:
I have been trained in REBT/CBT, plus TA, behavioural, psychodynamic and humanistic processes (thirteen systems in
all) - and my counselling and therapy work was supervised by Dr Ed Jacobs (for three years, up to February 2011).
I see my work as a combination of an empowering relationship
and a teaching/learning encounter. For some schools of counselling, the relationship is primary. For example:
Here is an illustration of a role played counselling session using the relational approach: Attachment theory suggests that the quality of care given to each of us by our parents in the first few years of life determines our 'attachment style' for all future relationships - whether secure or insecure. By analogy, we can say that a client in counselling and therapy needs a 'nurturing parent' relationship with their counsellor or psychotherapist, based on sensitivity and concern, care and attention. It is not sufficient to relate to the client as a 'thinking machine'. Non-possessive love is a key component of counselling and psychotherapy.
~~~ There are sixteen videos on various forms of counselling, here. ~~~ All systems of counselling and therapy are broadly equivalent in terms of outcomes achieved by clients For a number of years, I misunderstood the implications of the findings of Smith and Glass (1977), who found that all the therapies they investigated were "broadly equivalent", in that they each produced significant gains for the client. So, although the results tend to be listed hierarchically, and REBT is in the second position on their list, this variation in scores is not in itself sufficiently significant to place REBT in a league separate and apart from the therapies lower down the list. And there is now broad consent, in some research quarters, that all the major therapies that are designed to be therapeutic are broadly equivalent in their effectiveness. (See in particular the work of Professor Bruce Wampold)[1]. Therefore, it might be more productive to look at how and what we could each learn from the other, rather than competing in a zero sum game. Here is the abstract from Smith and Glass (1977) Meta-analysis of psychotherapy outcome studies, *American Psychologist*, September 1977, 752-760: "Results of nearly 400 controlled evaluations of psychotherapy and counseling were coded and integrated statistically. The findings provide convincing evidence of the efficacy of psychotherapy. On the average, the typical therapy client is better off than 75% of untreated individuals. Few important differences in effectiveness could be established among many quite different types of psychotherapy. More generally, virtually no difference in effectiveness was observed between the class of all behavioral therapies (systematic desensitization, behavior modification) and the non-behavioral therapies (Rogerian, psychodynamic, rational-emotive, transactional analysis, etc)". Page 752. In their conclusion, Smith and Glass say this: "The results of research demonstrate the beneficial effects of counseling and psychotherapy. Despite volumes devoted to the theoretical differences among different schools of psychotherapy, the results of research demonstrate negligible differences in the effects produced by different therapy types. Unconditional judgements of superiority of one type or another of psychotherapy, and all that these claims imply about treatment and training policy, are unjustified". Page 760. ~~~ [1] Wampold, B.E. (2001) The Great Psychotherapy Debate: Model, methods, and findings. Mahwah, NJ: Lawrence Erlbaum. And/or: Messer, S. and Wampold, B. (2002) Let's face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice. 9: 21-25. ~~~
~~~ If you like the content of this page, why not share it with your social networks? Click the button that follows: Thank you! :-) ~~~
We appreciate your generosity and support. ~~~ ~~~ Part Two In the UK there are 99 organizations representing counsellors, and each of
them varies somewhat in their emphasis on what counsellors do. Forty-six of those counselling organizations are (or have been
- directly or indirectly) in negotiations with the British government about professionalization of the field. "Counselling takes place when a counsellor sees a client in a private and confidential setting to explore a difficulty the client is having, distress they may be experiencing or perhaps their dissatisfaction with life, or loss of a sense of direction and purpose. It is always at the request of the client as no one can properly be 'sent' for counselling". This is a particularly 'non-directive' and 'non-interventionist' approach to defining counselling. Much of this definition would be acceptable to many counsellors in the UK today, although clarifying options for clients is increasingly common, and helping them to reach decisions of their own. For example, in the Egan Model (or the Skilled Helper model) of counselling, the central questions are: 1. Where are you up to right now? 2. Where are you trying to get to?3. What actions could you take to bridge that gap between where you are and where you want to be? And, again in the Egan model, the counsellor helps the client to see beyond their 'blindspots', and to identify their resources. And, in the Reality Therapy model, the questions are: 1. What do you want? 2. What are you doing (or have you been doing) to get what you want? 3. Let's evaluate how well that is going. 4. Let's produce a new plan, (if the current one is not working well). The CENT counselling approach goes well beyond this type of intervention, in recommending: meditation, critical thinking skills training, the study of REBT and TA models. CENT also focuses on the relationship as a 'secure base' for the client; and we use sensitivity and emotional availability as expressions of caring for the client. (See 'What is CENT counselling?, here) ~~~ In addition, we have the concept of "therapy", which comes from the Greek word for "healing".
And counselling and therapy, which overlap significantly, can be said to be in the business of "healing the life"
of the client. Or helping the client to "heal themselves". No attempt to distinguish counselling from therapy has
been particularly successful, and it is best to see "counselling and therapy" as a unified field of endeavour. (See:
Nelson-Jones, 2002, Essential Counselling and Therapy Skills, pages 4-5). And as Ed Jacobs says: "Impact therapists feel free to have a wide range of responses, including reflection, clarification, questioning, summarizing, probing and teaching". (Page 61). As practiced by Jim Byrne, counselling and therapy (and coaching), amount to helping the client to identify the source of their emotional or behavioural problems; and/or to refine their understanding of their practical problems; and/or to clarify their goals in relation to some developmental challenge; and/or to overcome their emotional, behavioural or relationship difficulties or problems. To understand how he operates as a counsellor is to perceive him as a "(relatively) wise philosopher who teaches what he has used to heal his own life, and to gain mastery over his own affairs". But he does this with one eye on the emotional component of the relationship with the client. And he is increasingly concerned with questions to do with how securely or insecurely the client is attached to significant others, and how to help them to develop secure attachments in all their significant relationships. To clarify this emphasis on feeling, emotion and affect, here is a final clip: What is Counselling? Part 2: ~~~ To support our public educational role, please make a donation:
~~~
~~~ Part Three The relationship between counsellor and client: Attachment theory in counselling and psychotherapy
Firstly, we can say that attachment theory has identified what is essential for healthy psychological development of every individual: (a) Initially, Dr John Bowlby gave emphasis to the idea that the parents should be accessible to the child at all times of need; and: (b) Later on, he emphasized that parents must be responsive as well as accessible. (This change was prompted by the research findings of Mary Ainsworth, who described the importance of the parents' sensitive responsiveness to the child's nonverbal signals). Secondly, when babies receive the attention they crave, they prove to be less needy than those babies who do not receive sensitive responsiveness when they cry. From this I infer that client's who get the kind of attention they need, will move on through their therapy much quicker, and more surely, than those clients who meet with cool and less responsive therapists. Third, Attachment theory suggests that collaborative communication is about getting to know the mind of another human being. (We may not consciously know that that is what is happening, and we might not use those verbal labels, but that, it seems, is what is nonverbally, and non-consciously, happening).
Fourth, it seems important to help the client to "feel felt" - that is, to see their nonverbal affective behaviours reflected in the nonverbal affective responses of the therapist. If the client cries, the therapist may reflect this by showing a sad face, ‘marked as' a reflection. Therapeutic communication needs to be collaborative - or shared - as well as contingent (each stimulus is shown a specific response; and each response produces a new reflection). In this process of collaboration and revealing the connections between stimulus and response, the therapist must aim for a high level of affective attunement: or ‘getting the client's emotional state' and reflecting it back in a different register. This process of providing affectively attuned responses to the client, which helps them to feel felt, probably depends upon intuitive right-brain communication, which depends less on words than on reading faces and body language, and responding with a good reflection of what is sensed. There is recent research from Germany that seems to suggest that this might be best facilitated by the kind of ‘mindfulness' which comes from having the therapist practice regular meditation. (Footnote[4]) When a client gets repeated experiences of this kind of emotionally attuned responsiveness, this may generate positive expectations of ‘feeling felt' - feeling understood and accepted by others - which may sediment into a secure model of a sensitive relationship; a working model of secure attachment. Or, as David Wallin puts it, "such experiences are lessons in how to have a comfortable and effective relationship - with oneself and one's emotions as well as with others". (Page 107). Of course, we must not create unrealistic expectations here. Counsellors and therapists, like mothers and fathers, are imperfect and error-prone humans. We cannot always ‘get it right' for our clients. But we should aim high. We should aim to get close to understanding where our client is coming from 5 times out of every 6; and we should learn how to track down and resolve any misunderstandings that arise between us. Clients can learn from us that misunderstandings can be resolved, and "distress can be weathered because it can be relieved", as David Wallin puts it. ~~~
~~~ More later. Meanwhile, you might want to take a look at the Attachment Theory and Counselling page. Or take a look at the page about Dr David Wallin's book on Attachment in Psychotherapy. Or follow the Happiness Blog, which discusses Attachment in Counselling and Therapy from time to time: The Happiness Blog. ~~~Further information: # What is TA counselling, as used in CENT? # What is Narrative counselling? # Introduction to the Six Windows Model of CENT counselling # The I-CENT Publications page ~~~ There are sixteen videos on various forms of counselling, here. ~~~ ~~~ ~~~ If you like the content of this page, why not share it
with your social networks? Click the button that follows: Thank you! :-) ~~~ |
Returning to the section of Chapter 7 of Dr David Wallin's book on 
The client needs to know which of their statements or actions produces which responses in the therapist. The therapist
must be transparent in showing the contingency (or dependence) of a particular response upon a particular stimulus
from the client. This is what helps the client to construct a model of ‘what is going on' in the mind of the other,
reflected in their own mind.