INTERVENTION WITHIN COUNSELLING SERVICES.

A Referral For Intervention Within Counseling Services

A Referral For Intervention Inside Therapy Services

“If counselling is to be one of the recognised interventions for promoting mental health and wellbeing to the public, then regulation, standardisation and consistency in practice are required.”(Sharman, Seber)1 (The school of Healthcare Counsellors and Psychotherapists, January 2004)

Counselling in primary care is provided by a wide range of health professionals, including general practitioners (GPs), health visitors, and community psychiatric nurses. This issue of Effectiveness Matters focuses on counselling provided by counsellors as a distinct professional group. What is counselling ? therapy has been defined as 'a methodical method which gives persons an opportunity to find out, find out and clarify ways of dwelling more resourcefully, with a larger sense of well-being. Counselling may be concerned with addressing and resolving specific problems, making decisions, coping with crises, working through conflict, or improving relationships with others.'1 Training Professional organisations such as the British Association for Counselling and Psychotherapy (BACP) recommend a minimum of a diploma course (450 hours training including skills and theory) and considerable supervised practice.2-4 Approximately half of the 9000 practices in England employ a counsellor. The NHS has not set specific standards for their training, although three quarters of counsellors report being qualified to the level recommended by the British Association for Counselling and Psychotherapy. Nearly all counsellors receive regular supervision (i.e. meeting with an experienced colleague to discuss clinical issues), in line with BACP requirements. Although the exact nature of counselling varies widely, the key characteristics of counselling in primary care are that it is brief (normally 6-12 sessions) and focussed on dealing with the patient's specific goal. Patient referral GPs mainly refer patients with stress and anxiety, depression, relationship and or/selfesteem problems; patients are often referred for bereavement counselling. Person-centred/experiential (PC/E) counselling and psychotherapy is a family of therapeutic practices in which clients are supported to find more satisfying and fulfilling ways of living through having an opportunity to explore their difficulties, strengths and resources in an empathic, non-judgmental therapeutic relationship with a therapist who is skilled in helping them develop a deeper awareness of their experiences and emotions. Personcentred/ experiential practice is an empirically-supported approach to therapy, demonstrably effective for a range of psychological difficulties strongly supported by a wealth of data from five complementary lines of converging evidence: Randomized comparative clinical trials and comparative outcome studies Controlled studies against untreated controls Naturalistic open clinical trials, showing large client pre-post gains Predictive process-outcome research showing that person-centred relationship qualities (empathy, acceptance, collaboration) are among the best predictors of positive clinical outcome Patient preference research. Rooted in a progressive, humanistic ethic, PC/E practice encourages clients to think of themselves as the experts in their lives, and to take responsibility for their own development and change. (Sibbald B, Addington-Hall J, 1996 Pp. 44)

In this respect, it is closely aligned to a patient centred healthcare agenda with an emphasis on a collaborative relationship between therapist and client, an integrated understanding of the patient's world, and ...