John McLeod

University ofAbertay, UK

Counselling has become established as a widely available source of help for people who are troubled by a range of different problems in living. It is available from a variety of different agencies in the statutory, voluntary and private sectors. In addition, many doctors, nurses, social workers and teachers have been trained in the use of counselling skills. Counselling represents a form of help and support that is well received by members of the public, who generally recognise the wisdom of finding 'someone to talk to' when faced by challenging life issues. However, perhaps reflecting the diversity of counselling practice settings and populations and the substantial degree of overlap between interventions that might be described as 'psychotherapy' and those that might be viewed as 'counselling', there have been difficulties in defining the nature and characteristics of counselling as a distinctive form of psycho-social treatment. Roth & Fonagy (1996, p. 255) have commented that counselling 'is a term that is poorly defined both in clinical practice and in the research literature.' There has also been a lack of clarity over the evidence base for the effectiveness of counselling, reflected in a paucity of published reviews or meta-analyses.

The aim of the present chapter is to offer an overview of current knowledge regarding counselling. First, the distinctive features of counselling, as a form of psychotherapeutic practice, are identified. Second, issues in evaluating the effectiveness of counselling are discussed. The chapter then examines research evidence with respect to three key areas of counselling provision: counselling in primary care, student counselling, and workplace counselling. Finally, conclusions and recommendations are offered, with specific attention to the implications of the research evidence for professional and organisational issues related to the delivery of services in resource-limited situations.

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