How do counsellors having menopausal symptoms experience their client work: An interpretative phenomenological analysis

Aim: The aim of this study was to discover if menopausal symptoms have implications for counsellors in their therapeutic work. Method: Semi-structured interviews were conducted with three counsellors who have experienced menopausal symptoms. The menopause is a unique experience for the individual therefore Interpretative Phenomenological Analysis (IPA) allowed for a detailed exploration of the participants’ experiences. Findings: Four superordinate themes were identified: transitioning personal and professional identity during menopause; the limited dialogue about the menopause; the ethical dilemmas of practicing as a counsellor when menopausal and the influence of menopausal symptoms during client work. The findings of this study demonstrated that the participants each had very personal and individual experiences of the menopause. A lack of knowledge and understanding of the menopause and limited dialogue within society to discuss symptoms was also reflected in the counselling profession. The capacity to continue working therapeutically presented potential ethical dilemmas which were affected by menopausal symptoms. Conclusion: Counsellors’ experiences of menopausal symptoms may create challenges in their therapeutic work, ranging from a mild distraction, a disconnection with a client, to the extreme of having to cease engaging with client work. Implications for therapeutic practice are discussed

‘So just to go through the options...’: patient choice in the telephone delivery of the NHS Improving Access to Psychological Therapies services

This article considers patient choice in mental healthcare services, specifically the ways that choice is enabled or constrained in patient–practitioner spoken interaction. Using the method of conversation analysis (CA), we examine the language used by practitioners when presenting treatment delivery options to patients entering the NHS Improving Access to Psychological Therapies (IAPT) service. Analysis of 66 recordings of telephone‐delivered IAPT assessment sessions revealed three patterns through which choice of treatment delivery mode was presented to patients: presenting a single delivery mode; incrementally presenting alternative delivery modes, in response to patient resistance; and parallel presentation of multiple delivery mode options. We show that a distinction should be made between (i) a choice to accept or reject the offer of a single option and (ii) a choice that is a selection from a range of options. We show that the three patterns identified are ordered in terms of patient‐centredness and shared decision‐making. Our findings contribute to sociological work on healthcare interactions that has identified variability in, and variable consequences for, the ways that patients and practitioners negotiate choice and shared decision‐making. Findings are discussed in relation to tensions between the political ideology of patient choice and practical service delivery constraints

Towards a systematic model of coaching supervision: Some lessons from psychotherapeutic and counselling models

Although recent research reveals a growing engagement amongst coaches with supervision, many coaches still pursue their professional practice without the support and guidance of a supervisor. Also, while the organisations that purchase coaching are clear that the coaches they hire should have supervision, they are unclear as to what forms that supervision should take. This article sets out to identify the kind of models of supervision that might be appropriate to coaches by exploring models and lessons from the supervision of counsellors and psychotherapist. Such models are valid because many current practising coaches are professionally trained as counsellors or psychotherapists, and a range of alternative supervisory models have been tried and evaluated over several decades. Applying elements of these models to a coaching context has allowed for the design of what is termed a systemic model of coaching supervision, with contracting, teaching and evaluation at its core. Models of the supervisory relationship are also discussed as important elements of the supervisor-coach alliance

‘Out on the edge of my comfort’: Trainee counsellor/psychotherapists’ experiences of spirituality in therapy: a qualitative exploration

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees’ experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists’ experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In-depth, semi-structured interviews were conducted, audio recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients’ spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients’ spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important as consideration for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered

How do we improve men’s mental health via primary care? An evaluation of the Atlas Men’s Well-being Pilot Programme for stressed/distressed men

Background Over three-quarters of all suicides are men (England and Wales), this is despite higher levels of anxiety and depression being reported by women. This disparity may in part be explained by atypical presentations of distress in men, and gendered issues around help-seeking. Consequently, the Atlas Men’s Well-being Programme was designed to engage stressed/distressed men who were patients at a London-based GP surgery. Atlas encouraged GPs to identify and refer men for counselling and/or acupuncture by raising their awareness of men’s distress. The aim of this pilot study was to evaluate Atlas in terms of patients’ characteristics, service utilisation, patient outcomes and cost implications. Methods All patients using the Programme were asked to complete a questionnaire before and after their Atlas sessions. Outcome measures included the Hospital Anxiety and Depression scale, Perceived Stress Scale, Warwick-Edinburgh Mental Well-being Scale, a 11-point scale measuring physical health, and the Psychological Outcome Profiles (PSYCHLOPS), a patient-generated outcome measure. Additionally, for cost calculations, participants were asked about their employment, number of days off work due to illness, and their health and social care service use. Results 102 participants were recruited, 82 completed pre- and post-treatment questionnaires. Comparisons pre- and post-treatment revealed a statistically significant improvement in anxious mood (p <0.001), perceived stress (p < 0.001), positive well-being (p = <0.001), PSYCHLOPS (p = <0.001) and physical health (p = 0.001), though not depressed mood (p = 0.660). Additionally, reductions in costs related to lost employment and health and social care use, exceeded the cost of Atlas counselling and acupuncture sessions, with an average saving of nearly £700 per patient. Conclusions Atlas attendance was associated with improvements in patients’ mental and physical health, and demonstrated likely cost savings. It is now important to understand patient and stakeholder perspectives. Further research could compare usual care with the Atlas approach, and investigate full cost-effectiveness

A case for taking the dual role of counsellor-researcher in qualitative research

This is an Accepted Manuscript of an article published by Taylor & Francis in Qualitative Research in Psychology on 3rd August 2016, available online: https://doi.org/10.1080/14780887.2016.1205694There is ongoing debate about whether the challenges of practice-based research in counselling, with clients’ discourses providing the raw data, can be overcome. This article begins by considering the argument of whether taking a dual role of counsellor-researcher within case study research is a legitimate qualitative approach. A case example using sand-tray in short-term therapy with adults from a pluralistic perspective is provided to demonstrate how the challenges of the dual role can be managed to produce effective research findings. It is suggested that this approach closes the gap between research and practice to produce findings that are highly relevant to the counselling context. The ethical considerations of taking a dual role of counsellor-researcher are considered, and opportunities and challenges when adopting this approach are identified

Counselling in primary care in the context of the NHS Quality Agenda The facts

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