What Is Counselling

Historically, counselling and psychotherapy have been largely similar forms of practice in terms of the underlying theoretical rationale on which they are based, the training of

Handbook of Evidence-based Psychotherapies: A Guide for research and practice. Edited by C. Freeman & M. Power. Copyright © 2007 John Wiley & Sons, Ltd.

therapists and the types of clients that are seen. Any approach to psychological therapy, whether labelled as counselling, as psychotherapy, or in other terms, relies on the development of a relationship between therapist and client/patient in which the latter becomes able to talk about problematic or painful aspects of their life, is offered a framework within which to understand these difficulties, and constructs personal strategies that enable learning, resolution and coping. However, despite the shared conceptual underpinnings of counselling and psychotherapy, there has been a growing divergence between these activities in terms of how these principles are applied in practice, leading to an increased recognition of counselling as a distinctive professional specialisation. The defining features of counselling can be described in the following terms:

• A relational approach. Counselling is built around a relationship of trust in which collaborative working is emphasised.

• Contextualised knowledge/practice. Counselling is almost always provided in specific settings or for specific social groups (infertility counselling, student counselling, marital/relationship counselling). As a result, psychotherapeutic theories and models are integrated with knowledge regarding the life situation of the person seeking help: the client is viewed as living within a social context, and struggling to resolve specific life issues.

• Flexible approach, guided by the needs of the client. Counsellors do not follow predefined treatment manuals, but work with the client to find strategies that are appropriate to individual circumstances.

• Sensitivity to issues of power and control. A central aim of counselling is that of facilitating the person's sense of being an agent, able to take action in the world. Interventions that might be perceived by the client as an imposition of external authority (for example, making a psychiatric diagnosis) are rarely used.

• Resource-oriented approach. Counselling gives no special priority to analysing the origins of problems unless the client decides that this would be helpful. Instead, counsellors aim to empower clients to make use of whatever personal and cultural resources that are available to them.

• Negotiated outcomes. The goals and outcomes of counselling, and criteria for success, are agreed between the client and practitioner on an individual basis.

• Voluntary participation. A person who enters counselling does so on the basis that he or she is taking personal responsibility for being there and for termination.

The implementation of these principles results in a psychotherapeutic service that is usually delivered on a one-to-one or couples basis. The importance of client empowerment within the counselling process means that, ideally, counselling will continue until client and counsellor negotiate a mutually acceptable ending. In practice, the majority of people who make use of counselling expect to receive, and attend, around six to eight sessions. There are some clients who appear to benefit from one or two sessions and a small group that require a long-term relationship with a counsellor. The community-based location of many counselling services means that some clients consult their counsellor intermittently, rather than for a sustained series of sessions in any one treatment episode. An understanding of counselling is not possible in the absence of an appreciation of the characteristics, training and working patterns of counsellors. It is important to note that the shape of counselling as a profession differs substantially across national boundaries -these observations refer primarily to the situation in the UK. Counselling training typically involves a three- or four-year part-time programme, encompassing counselling skills and theory, professional issues, personal development, research awareness and a practice placement, normally at postgraduate diploma or masters level. Professional accreditation, for example by the leading body in the UK, the British Association for Counselling and Psychotherapy, will normally require at least two years of post-qualification supervised practice and ongoing commitment to continuing professional development. The majority of counsellors enter training in their 30s or 40s, having previously worked in a profession such as nursing, social work, teaching or the clergy, or having engaged in voluntary work. Counsellors are a highly interdisciplinary workforce, with only perhaps 20 % having completed a psychology degree, whereas others bring into their work concepts and epis-temologies derived from the arts, sciences, social sciences, humanities and professions. Regular clinical supervision, and ongoing personal development (often through participation in personal therapy) are mandatory for members of the counselling profession in the UK. These features are consistent with, and a necessary part of, an approach to practice that highlights the importance of the relationship between counsellor and client - counsellors tend to be people whose early career has given them experience of many different types and intensity of professional relationship. The requirement for supervision, consultation and personal therapy means that professional effectiveness is maintained through a network of relationships with colleagues.

In addition to a core professional cadre of around 20 000 fully qualified counsellors in the UK, there are also many other people who are trained to a paraprofessional level and offer counselling through voluntary agencies and helplines, as well as nurses, social workers and other human services personnel who have received training in counselling skills. It is important to note that the standard of training in many voluntary agencies matches or exceeds the accreditation criteria of BACP.

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