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The Counsellors Workbook

Second Edition
Second Edition
The
Counsellors
Workbook
Developing a Personal
Approach

John McLeod
Open University Press
McGraw-Hill Education
McGraw-Hill House
Shoppenhangers Road
Maidenhead
Berkshire
England
SL6 2QL

email: enquiries@openup.co.uk
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First published 2010

Copyright John McLeod 2010

All rights reserved. Except for the quotation of short passages for the purpose of criticism and
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A catalogue record of this book is available from the British Library

ISBN-13: 978-0-33-522871-3
ISBN-10: 0335228712

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Printed in the UK by Bell and Bain Ltd, Glasgow

Fictitious names of companies, products, people, characters and/or data that may be used herein
(in case studies or in examples) are not intended to represent any real individual, company,
product or event.
Dedication
For Julia
Contents

Acknowledgements xi

How to use this Workbook 1

Introduction 3
Learning to offer a therapeutic relationship 3
Using the Workbook 5
Some practical suggestions 5
Working alone and with others 6
Taking responsibility and taking care of yourself 7
Building a portfolio of experiences and reflections 7
The basic assumptions informing the design of this Workbook 9
Notes for tutors 10

Section 1 Building on life experience: the foundations of a


personal approach 13

Introduction 15
Writing your autobiography: getting started 17
Keeping a personal journal 18
The story of a helping relationship 19
The origins and development of your interest in therapy 20
Your favourite story 21
The self puzzle 23
Thickening your autobiography: early memories 24
An inquiry into sexuality 25
Your personal experience of therapy 26
What you bring to counselling 27
Exploring cultural identity 29
Feeling really understood 31
Mapping your relationship patterns 33
Engaging with difference 34
How do you cope with crisis in your own life? 36
The experience of changing your own behaviour 37
The role of therapy in your life story 38
Knowing how your emotions are organized 40
What is your psychopathology? 42
How relevant is spirituality? 43
How do you cope under pressure? 44
Do you have a preferred learning style? 45
What motivates you? 47
Reflecting on the experience of writing about yourself 48

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viii The counsellors workbook

Section 2 Being a member of a learning group: working together to develop


self-awareness 51

Introduction 53
Exploring your feelings, fantasies and expectations about the group 55
Using the group to experiment with new ways of relating to others 56
Making connections and being responsive to others 57
First impressions of group members 59
Talking about yourself in the group 61
Reflecting on significant events in the group 62
Endings: reflecting on the life of the group 64
A brief introduction to concepts of group dynamics 66

Section 3 Making sense: constructing a framework for understanding 71

Introduction 73
What are the key theoretical ideas that you use? 75
What is your relationship with theory? 76
Identifying different levels of theorizing 77
Meta-theories: how do they shape the way you think about counselling? 79
Applying theory: making sense of personal experience 81
Empathy: a key concept in counselling 83
Making sense of self 85
How theory is applied in practice: key cases 87
Applying cognitivebehavioural concepts 88
Irrational beliefs and dysfunctional self-talk 90
Developing a cognitivebehavioural case formulation 91
Congruence: the use of self in counselling 92
Experiencing authenticity 94
The balance between problems and solutions 96
Specific techniques or common factors 98
Positioning your practice in relation to social and political factors 100
The idea of the unconscious 101
What brings about change? The relative importance of cognition and emotion 103
Behind the theory: the life of the theorist 105
The cultural context of understanding 107
What kind of therapeutic relationship? 108
Dialogue between theorists 110
Are you postmodern? 112
Letter to a theorist 114
The concept of transference 115

Section 4 Putting theory to use: thinking about cases 117

Introduction 119
Student counselling: the case of Ms B 120
A clients opening statement 122
Cynthia: making life choices 124
The case of Glenys first session 126
The case of Glenys later sessions 128
I hear these voices telling me what to do 130
A case of work stress 132
Contents ix

Thelma: a victim of therapist boundary violation 133


Geoffrey: deconstructing demons 135
The case of Mrs Y 137
Charles: therapy as a last resort 139
The case of Ida 141
Anna: moving on in life 143
Case scenarios for working with emotions 145
David: tackling self-blame 146

Section 5 Reflecting on practice: challenges and possibilities within the


therapeutic relationship 149

Introduction 151
Exploring moral values 152
The implications of your moral values for your approach as a counsellor 154
What is your personal philosophy? 155
Moral dilemmas presented by clients 157
Ethical decision-making 159
Deconstructing the meaning of confidentiality 161
Creating and maintaining a therapeutic relationship with a client 162
Expanding your relational responsiveness 163
Touching and being touched 165
Making sense of stories 167
Working therapeutically with metaphors 169
Responding to client interest in dreams 171
The meaning of boundary 172
What does counselling mean to people in your community? 173
Writing letters 174
The therapeutic use of reading 176
Using Internet resources to support therapy 178
Counselling in the media 179
Online counselling 180
Indoors or outdoors? Using nature in therapy 181
How to be really ineffective 183
Working with clients who are difficult or challenging 185

Section 6 Developing a professional identity: putting it all together 187

Introduction 189
Reviewing your skills and qualities as therapist 190
Images of therapy 191
What are you aiming to achieve as a therapist?: selecting criteria for evaluating
your effectiveness 192
Whats in your toolbox? 194
Marketing yourself as a counsellor: your one-minute intro 196
Are you a counsellor or psychotherapist? 197
Your therapy room 199
Building an effective support network 200
Your position in relation to research and inquiry 202
What does it mean to be personal?: some questions from Carl Rogers 203
Ten years from now 204
Critical issues for counselling and psychotherapy 205
x The counsellors workbook

Internet resources and further reading 206

Appendix A: A narrative approach to personal and professional development in


counselling/psychotherapy training 209

References 215

Index 221
Acknowledgements

This Workbook is the product of many years of teaching on counselling courses. Inevit-
ably, it contains ideas that I have come across in books and articles, training courses I
have attended, and colleagues handouts and worksheets. If I have neglected to give
proper recognition to anyone whose ideas have been used, please let me know, so I can
properly acknowledge your contribution in future editions. I have particularly appreci-
ated the inspiring examples of teaching and training that I have observed in the work of
these valued colleagues: Joe Armstrong, Art Bohart, Anne Chien, Mick Cooper, Edith
Cormack, Elaine Craig, Robert Elliott, Kate Lanka, Noreen Lillie, Mhairi Macmillan,
Dave Mearns, Peter Rober, Brian Rodgers, Alison Rouse, Karen Tallmann, Mhairi
Thurston, Dot Weaks, Sue Wheeler and Mark Widdowson.
I would also like to acknowledge how much I have learned from my students.
The love, support and encouragement of my wife Julia, and my daughters Kate,
Emma and Hannah has been, as ever, essential for the completion of this book.
John McLeod

xi
How to use this
Workbook

Section contents
Introduction 3
Learning to offer a therapeutic relationship 3
Using the Workbook 5
Some practical suggestions 5
Working alone and with others 6
Taking responsibility and taking care of yourself 7
Building a portfolio of experiences and reflections 7
The basic assumptions informing the design of this Workbook 9
Notes for tutors 10

Contemporary psychotherapy proposes a framework of theory within


which the practitioner may, to a certain degree, reveal ordinary human
qualities. By contrast I would suggest that psychotherapy is the manifest-
ation of creative human qualities in a facilitating setting, in which the task
of healing is eased by a critical knowledge of the theories and techniques
of twentieth-century practitioners.
(Lomas, 1981: 3)
. . . the actual techniques employed by the therapists are of lesser
importance than the unique character and personality of the therapists
themselves. Therapists select techniques and theories because of who
they are as persons: therapy strategies are manifestations of the therap-
ists personality. The therapist as a person is the instrument of primary
influence in the therapy enterprise. A corollary of this principle is that
the more a therapist accepts and values himself, or herself, the more
effective he or she will be in helping clients come to know and appreciate
themselves.
(McConnaughy, 1987: 304)

1
2 The counsellors workbook

. . . in the end, each therapist develops his or her own style, and the
theoretical orientation falls into the background. What remains salient
is a unique personality combining artistry and skill. In this respect, a fine
therapist closely resembles a painter, novelist or composer. As is true in
all the arts and sciences, few reach the summit.
(Strupp, 1978: 31)
More and more, as time has gone by, I have thought that the usual way
of training is not satisfactory in that it does not give enough weight to the
general way a person behaves and thinks and feels toward someone who
is distressed, to the experience of being with people and of getting as
much help as possible from colleagues and supervisors. There is too
much stress placed on working with particular techniques. . . . I think
therapy is very much a personal affair. It is not wise to try to make clones
of people by making them Freudians or whatever. Student therapists have
to find their own way of being with people that will help them. One can
expose them to all sorts of marvellous [theorists], and it will do them a lot
of good, but that is not the business. The business is to do with finding
their own way, using their own intuition, learning to be themselves in the
presence of someone who is asking for help, who is probably putting all
kinds of pressures on them.
(Lomas, 1999: 25)
3

Introduction

For anyone to become a counsellor or psychotherapist, there is typically a period of


three or four years of intensive learning and training. Even if this training is part time,
with the person continuing to fulfil other ongoing work and caring roles, it is usual for
the person to become fully immersed in the whole process of becoming a counsellor
or psychotherapist: reading widely, reflecting on relationships with trainers/tutors and
fellow learners, making sense of what emerges from personal therapy or groupwork,
and seeing clients under supervision for the first time. The Counsellors Workbook has
been created as a tool for further personal exploration of the key issues that emerge
for people during this crucial phase of development as a therapist. The Counsellors
Workbook has been designed as a companion text to accompany the use of An Intro-
duction to Counselling, 4th edition (McLeod, 2009). However, the range of issues that it
covers makes it an appropriate companion piece to any mainstream counselling or
psychotherapy text.
To be an effective therapist, it is necessary to develop a way of being with people that
is genuinely grounded in ones own personal experience, values and cultural context.
Over and over again, research studies have found that what makes a difference to
clients are the personal qualities of the counsellor, and his or her capacity to form an
accepting and facilitative relationship. The Workbook has therefore been organized
around a series of reflective learning tasks, which invite you to explore aspects of your
own life that are relevant to your capacity to offer an effective counselling relationship
to others. The aim is to help you to get inside the various ideas and approaches that exist
within the domain of counselling.
It is recommended that you read through this introduction before attempting any of
the learning activities in later sections of the Workbook.

Learning to offer a therapeutic relationship


There are three core aspects of learning about counselling or psychotherapy. These are:
G self-awareness;
G understanding the therapeutic process;
G practical experience.
Accurate and sensitive self-awareness underpins any type of counselling work. No
matter what approach to counselling or psychotherapy is being used, the main instru-
ment for delivering help or therapy is the person or the counsellor him or herself. To be a
therapist involves interacting with the person seeking help in a flexible and responsive
way. There is no fixed script that a therapist can follow: almost everything is improvised
in the moment. It is essential, therefore, for a therapist to be able to use him or herself as
a resource: to be sensitive to the possible significance of shifts in internal feeling states,
4 The counsellors workbook

to have a sense of how his or her actions might be perceived by another person and to
have strategies for staying fresh and alert. Effective therapy builds on the quality of
the relationship between helper and person being helped, and being a therapist fre-
quently stretches and challenges a helpers capacity to relate: to cope with endings,
confrontation, the experience of deep caring and the intricacy of unravelling impasses.
In recognition of these factors, all counselling or psychotherapy incorporates an elem-
ent of work on self; for example, participating in experiential groupwork, gaining the
experience of being a client, or keeping a personal reflective journal. Throughout the
Workbook you will find that you are invited to write about yourself, to reflect on your
own experience and hopefully to gain new insights into yourself. It is important to
experience this process (not only through the medium of a workbook but also through
being a client yourself at some point in your life), because this is the process that anyone
receiving therapy goes through.
In addition to self-awareness, it is necessary for counsellors or psychotherapists
to develop a framework for understanding what they are doing. There has been
much debate about whether it is better for counsellors to stick to one theoretical model
(e.g. the person-centred approach of Carl Rogers, or a Freudian psychodynamic
approach), or whether it is more effective to piece together an integrated personal
model from the various theories that are around. Each of these strategies can be effect-
ive, but what is crucial for therapists is to use concepts and ideas that are coherent and
make sense to the person who is using them, and that they can communicate to the
people they are trying to help. The importance of developing a robust framework for
understanding really stems from the fact that, quite often, people who come for therapy
are confused and confusing. They have exhausted their immediate problem-solving
resources such as friends and family. They may be in crisis and feel that everything is
chaotic and out of control. They may well be afraid of what they feel is happening
to them. And they may, one way or another, push all this stuff on to the therapist:
here, you deal with all this chaos, fear and confusion. It is at this point that a therapist
needs to feel secure in his or her grasp of reality. The Workbook, as a consequence,
includes many tasks that are intended to give opportunities for those who are becoming
therapists to piece together and test out their evolving framework for understanding.
The third key element of counselling and psychotherapy training, which goes hand
in hand with self-awareness and developing a framework for understanding, is that of
practical experience. There are three types of practical experience that are particularly
relevant. The first involves simply sharing personal experience with others, and hearing
about their experiences. The second type of practical experience concerns practising
counselling and helping skills on and with fellow learners. The third form of practical
experience involves being in a real counselling role with someone who has come for
help with their problems. This Workbook cannot directly facilitate the development of
practical experience. However, it does provide opportunities to reflect on personal
experience. When learning the practice of counselling or psychotherapy, it is absolutely
essential to be a member of some kind of small peer learning group that meets often
enough for a climate of trust and honesty to be created, where members can be sup-
ported as well as challenged, and can learn to give and receive feedback. Being able to
draw on the knowledge and expertise of a tutor or trainer is important too; to provide
guidelines and standards and to model good practice. Many of the learning tasks in the
How to use this Workbook 5

Workbook lend themselves to exploration in a small group setting; the depth and sus-
tainability of the learning that you can achieve through using the Workbook will be
multiplied many times by exploration of learning tasks in the context of an ongoing
group.

Using the Workbook


There are a large number of learning tasks and activities in this Workbook. It is unlikely
that anyone will want to try them all. Some of the tasks may introduce areas of self-
reflection, contemplation and dialogue with others that may expand to fill many hours
of time. Other tasks may seem uninteresting, trivial, or evoke a response of not yet. Yet
other tasks may stimulate reading and thinking around the topic, in advance of tackling
the learning activities. It is important, when using the Workbook, to trust your own gut
feeling regarding the best direction for your own learning at any one time. This is also,
possibly, one of the primary rules of therapy: the clients readiness to explore any
particular issue is a factor that is taken into account by all the main approaches to
counselling (although in different ways). The Workbook has been written as a resource
that can be relevant for counsellors and psychotherapists with different interests and
needs, so it is inevitable that there will be some activities that are more relevant for you,
while others are less relevant.
The structure of the Workbook has a beginning and an end. The activities in Section 1
are intended to allow you to explore and honour your own experience and knowledge
as a person who can engage constructively and helpfully with others who need to talk
about their problems. It is essential that you complete at least four or five of the activities
in this section before you attempt to begin working in any of the other sections, or
before you even look at the exercises in these later sections. There are several activities
in later sections, for example, that invite you to reflect theoretically on aspects of your
personal story that you have written in response to the tasks in Section 1. It is best to
have already completed as many of your personal stories as possible in an intuitive,
expressive, open and spontaneous manner, rather than writing them with half a mind to
how they might be interpreted.
Section 2 is specifically focused on the possibilities arising from using the Workbook
in the context of a learning or personal development group.
The activities in the final section, on integration, achieving a sense of professional
identity, and reflecting on the experience of working in a group, are intended to be
completed during the later stages of using the Workbook. These are activities that invite
you to bring together and review themes and ideas from earlier sections. The activities
in the middle sections theory, practice and cases can be taken in any order.

Some practical suggestions


The Workbook is designed as a series of learning tasks, each of which will generate
written material that can be included in a portfolio or journal; this could be in the form
of a paper notebook, ringbinder or files in a folder on a personal computer.
6 The counsellors workbook

Many counselling and psychotherapy courses require students or trainees to keep


personal learning diaries or journals, because it has been found that this is an excellent
way of helping people to explore personal experience, reflect on experience, and inte-
grate theory and practice. A learning journal also makes it possible to keep track of
personal change and development, and to keep hold of new insights (by writing them
down) rather than losing them through forgetting. There is also a lot of evidence that
writing can in itself be therapeutic (at some point in the future you may want to suggest
to some of your counselling clients that they might want to keep journals). Section 1 of
the Workbook offers some guidelines for writing a personal journal.
The Workbook deliberately does not specify how long each task might take, or how
much written material it might generate. There are no right or wrong answers what is
important is what you learn.
Most of the learning tasks in the Workbook include suggestions for further reading,
either in the form of chapters or sections in An Introduction to Counselling or specific
books and articles. It is important to complete the learning task activity before consult-
ing the recommended reading. In order to develop a personal understanding, it is
essential to take ones own experience as a starting point, and then to use the ideas of
others to place this experience in a wider context.

Working alone and with others


All the tasks included in the Workbook are primarily designed to promote individual
learning, through personal reflection and writing. This emphasis on person or individual
learning is a requirement in any counselling or psychotherapy learning programme, and
reflects the centrality of self-awareness in therapy. The majority of the activities in the
Workbook involve periods of sustained reflection on personally significant topics. There
is a great deal that can be learned from this. However, working with other people on
these tasks introduces important additional opportunities for learning:
G The experience of what it is like to share your feelings and thoughts, and your
story, with others; for example, how risky does this seem to be, are there things
you could say but hold back on?
G The response of other people to what you have said do they appear to be inter-
ested, involved, shocked, surprised . . .? When others ask questions about what
you have offered them, do these trigger new ways of looking at the issue?
G Observing and listening to your colleagues sharing their responses to the learning
activities in what ways might this broaden your appreciation of the range of
possible perspectives that there might be on an issue?
It can be very helpful, therefore, to have a learning partner or partners, or to be a part of
a group, with whom the issues raised by this Workbook can be shared and explored.
Such learning alliances may be facilitated or led by a trainer or tutor (e.g. as part of a
training course) or may be organized on a peer group basis. In either case, there are
ground rules that should be discussed, understood and adhered to. The existence of
confidentiality is a necessary element: it can be destructive and damaging if personal
information that is shared in the context of this type of learning is passed on to others
How to use this Workbook 7

without permission (even if for the best of intentions). The existence of respect is
also necessary people learn best at their own pace, and when the conditions are right
for them.
Section 2 of the Workbook includes a series of learning activities designed to
explore some of the unique opportunities for learning that arise when working in an
intensive learning group with a set of colleagues. Appendix A (p. 209) provides some
suggestions for how such a learning group might be organized and facilitated.

Taking responsibility and taking care of yourself


Some of the learning tasks in the Workbook invite you to explore intimate and sensitive
parts of your own life. Some of the tasks ask you to write about things that maybe you
have never told anyone else, or are emotionally painful.
When using the Workbook, remember that:
G you are responsible for your own learning. If a task does not appeal to you, or
seems threatening, then do not do it. It is your choice;
G you do not have to show anyone else what you have written unless you decide to.
No one has the right to see what you have written. Its up to you to share what you
are comfortable sharing;
G keep what you write in a safe place;
G if there is anything in the Workbook that disturbs you, then it may be helpful to talk
it over in confidence with a friend or colleague, a tutor (if you are enrolled on a
course), or with a therapist or spiritual adviser. If you find yourself coming back to
a Workbook topic, in your own mind, days after writing about it, then this may be a
signal that it has raised a significant issue that may repay discussion with another
person.
Your experience of using the Workbook may mirror the experience of being a client in
therapy. There may be times when you avoid the Workbook or forget about it. There
may be other times when you tackle learning tasks with great energy.

Building a portfolio of experiences and reflections


The Workbook is intended to help you to work towards developing and demonstrating
competence as a therapist, by accumulating a portfolio of notes, stories and ideas that
you can use to inform your thinking about therapy and your confidence in what you
bring to the therapeutic relationship. This portfolio may supplement a learning journal
or diary that you keep, or it may be quite separate.
In all likelihood, many of the assumptions that you hold about therapy are implicit
rather than explicit. In other words, you may have a gut feeling that some approaches
and techniques are better than others (at least for you, or in your work context), but it
may be hard to put into words exactly where you stand, and why. The learning tasks in
the Workbook give you opportunities to put these ideas into words.
It is essential, in using the Workbook, that you actually take the time to write down
8 The counsellors workbook

your responses to tasks. The process of writing will help you to articulate or sort
out your ideas in a focused way. Recording your reflections in writing also makes
it possible to add more later. It allows you to reflect on what you have written, and to
de-centre yourself. Writing also enables you to reflect on how you may have changed,
or on the different voices or feeling states that appear in your words.
The portfolio will give you a rich supply of experiences and reflections that will help
you to define many different aspects of yourself as a counsellor.
By the end of your involvement with the Workbook, your portfolio could contain:
G your responses to the learning tasks provided in the Workbook;
G material from exercises that may have been used on courses or workshops you
have attended;
G notes or excerpts you have taken from books and articles you have read, which are
relevant to the task of mapping out your own personal understanding of counselling;
G copies of web pages that have been of interest to you;
G personal reflections.
The Workbook is envisaged as a way of supporting your learning about therapy,
through providing a structured way of exploring, recording and analysing key dimen-
sions of your therapeutic competence. When you have completed training, or moved
from a period of learning into a stage in which practice has the predominant call on
your time and energy, the pressure to record so much information will not be so
great. Although you may well find that you have got into the habit of writing about
yourself, and building your personal portfolio, you will probably also find that it
has mutated into a style and format that is uniquely your own (like your counselling
style!).
It is not helpful to view the Workbook as a self-contained exercise it should
connect with other facets of your learning and practice. Some suggested ways of using
the Workbook and your portfolio to augment other aspects of your training are:
G identifying what you are good at and what you need to work on. During training
you will get lots of opportunities to practise on and with colleagues, or discuss
issues. What you write in the Workbook can help you to be clear about what
would be best for you to focus on. For example, perhaps you can see in your
Workbook entries that over and over again you have difficulty with challenging
people, or with ending relationships. These may be key areas for further work,
because they are so critical to being a good therapist;
G building up a pool of ideas and insights that you can draw on when writing articles,
giving talks, or for coursework essays, case studies and other assignments;
G integrating what you have learned in personal therapy, experiential groups and
supervision. During training, people often spend a lot of time and effort on their
personal therapy or supervision, but find it difficult to link up this learning with
their theoretical framework, or their practice;
G helping you to be clear about the issues you might want to explore in personal
therapy or supervision;
G being clear about who you are and what you do. Developing a professional
How to use this Workbook 9

identity. When you are interviewed for a job, or if you work in a setting where you
need to give clients a leaflet describing your approach, you need to sum up your
style and qualities as a counsellor in a few words. Some of the Workbook tasks may
help you to clarify your career direction;
G as a source of support. Becoming a counsellor or psychotherapist can be a stressful
or even harrowing business. For example, clients or fellow trainees may give you
feedback that is hard to take on board. A learning journal or portfolio is a place
where you can begin to look at what they have said, and how you feel, and make
some sense of it;
G some learning tasks help you to build up information about local resources that
you can use in your role as counsellor; for example, various agencies and facilities
that you might suggest that your clients make use of, or details of self-help books,
articles and leaflets that clients might find helpful.
These are just some of the more obvious ways of using the Workbook during your
period of training. What is important is not to see the process of writing in using this
Workbook as a chore or empty ritual, but to keep in mind the advantages of gradually
building up a portfolio of your knowledge, practice and achievements.

The basic assumptions informing the design of


this Workbook
The exercises and guidelines provided in the Workbook reflect a set of assumptions
about what counselling is about, and what is involved in becoming an effective coun-
sellor or psychotherapist:
G There is no single approach to counselling or psychotherapy that is more effective
or valid than any other. There is clinical and research evidence that supports (and is
critical of) all the established therapeutic approaches. In a professional environ-
ment in which a plurality of approaches are applied, and where a counsellor may
find him or herself working alongside colleagues representing a wide array of
models, it is essential to be familiar with the principal ideas of all the mainstream
approaches;
G Effective counselling and psychotherapy is largely dependent on the personal qual-
ities of the therapist, such as his or her capacity to form a connection with the
client, the possession of a model of practice that he or she has worked out for him
or herself, and a sufficient degree of consistency between his or her therapeutic
approach and who he or she is as a person;
G At the heart of therapy is the opportunity it provides for the person to tell (and
retell) their story, to a listener who will be curious, sensitive and accepting. Good
counsellors and psychotherapists are people who tune into the rich meaningful-
ness of the stories that other people tell, and are able to draw on an appreciation of
the meaningfulness of their own life story;
G Therapy is a highly moral activity, and requires a genuine commitment to truth,
honesty and a valuing of relationship and conviviality;
10 The counsellors workbook

G Counselling is an activity that is much wider than the work of counsellors. Most of
the time, people who need to talk find themselves a suitable friend, health worker,
teacher or clergy.
Learning is most effective when it builds on personal experience, and recognizes the
existing knowledges, skills and personal qualities of the learner. The sequence of learn-
ing in this Workbook begins by inviting exploration and documentation of an area of
personal experience, then moves into reflection on the potential meaning or signifi-
cance of that experience, then makes links with theory and research, before finally
giving consideration to implications for practice.
Beyond this emphasis on the importance of developing a personal approach is the
idea that being a person involves being in relation with others, and that, ultimately,
building a personal approach can only be done with the help and collaboration of other
people. In terms of becoming a counsellor or psychotherapist, there are some relation-
ships that appear to be more or less essential:
G being a member of a peer group that offers support and challenge, over an
extended period of time, from a basis of equality of status;
G having contact with mentors more experienced members of the profession
who can provide inspiration, affirmation and immersion in the discourse of the
profession;
G being in a clienttherapist relationship, in the clients chair, and having personal
experience of what this situation feels like, and what makes it work better (and
worse).
What this means, of course, is that a Workbook such as this can only ever be a resource,
or a tool. It can never be a substitute for the real business, which is always about
working together with others. But it may, hopefully, provide a structure or a meeting
place around which this kind of co-operative learning can take place, as well as facili-
tating personal reflection on a wide range of personal experience that is relevant to the
practice of therapy.

Notes for tutors


The Counsellors Workbook is intended as a resource to support those at the stage of
basic training in counselling or psychotherapy (in the UK, this would be diploma level),
rather than those participating in more introductory skills courses. As explained in the
Introduction, the underlying philosophy of the Workbook is that counselling is an
intensely personal activity, and that it is essential that theories and methods are assimi-
lated and integrated into the counsellors sense of who he or she is, rather than being
ideas or techniques that are bolted on.
At the heart of any training course is the capacity for the trainer to convey his or her
truth to the trainee, in the form of lectures, workshops and handouts that reflect the
trainers personal and professional experience. There is no way that this Workbook is
intended to replace learning activities that a trainer or staff team have devised, or form
the basis for a whole syllabus. The aim of the Workbook, instead, is to play a role as a
supplement to an existing programme or curriculum.
How to use this Workbook 11

There are a number of ways in which the Workbook can be used in the context of a
counselling or psychotherapy training programme:
1 Independent study/background reading: many students on therapy courses are
very keen to learn, and quickly work their way through recommended texts and
reading lists. There is plenty in this workbook to keep such students busy. Particu-
larly if An Introduction to Counselling is the core text for the course, or one of a
set of core texts, students are likely to find the Workbook valuable as a means of
linking together themes and issues that are dealt with in different chapters, and
making connections between concepts and personal experience.
2 Building experiential workshops or seminars around specific learning tasks: many
tutors and trainers like to organize classes on a workshop basis, with students
engaging in an experiential exercise, or exploring case material, then coming
back together for a group discussion. Many of the learning tasks in the Workbook
may be applicable in such situations, and have the advantage of being referenced
both to a textbook and to other activities that the student might wish to pursue.
Because the learning tasks are presented in a workbook format, they can be given
to students as homework assignments, thus giving more time for participative
work when the group actually gets together in class. The learning tasks and activ-
ities included in the Workbook encompass many of the central topics covered in
most counselling courses: self-awareness, theory and ethical issues. The Work-
book does not include inputs on counselling skills, or on preparation for practice,
because these are topics that require direct tutor involvement and guidance.
3 As the basis for a peer- or facilitator-led personal development group, learning
set or study group: although the Workbook is written in such a way as to make it
possible for students to use it on an individual basis, the majority of the learning
tasks are likely to produce deeper and more significant learning if they are
shared in an ongoing small group. Appendix A: A narrative approach to personal
and professional development in counselling/psychotherapy training offers some
guidelines for learners who might wish to work on workbook activities in a group
setting.
4 As the basis for assessment tasks: the Workbook can be valuable in relation to
student assessment. On some courses, students are required to submit a personal
learning journal, or report based on their personal learning journal. In this situ-
ation, it may be helpful to point students in the direction of relevant Workbook
activities, for example in the opening section, as a focus for at least some of the
content of their personal journal. The Workbook also includes a page on keeping
a learning journal. Another assessment possibility is to base assignments on spe-
cific learning tasks. Almost all the tasks involve doing some writing. By indicating
a limit to this writing (e.g. 10001500 words), and maybe also requiring the
student to discuss their self-exploration in the context of relevant theory and
research (material in An Introduction to Counselling can serve as the staring point
for such discussion), almost all the learning tasks/activities could form the basis
for coursework assignments. A third possibility, in relation to assessment, is
to invite students to submit a portfolio of their writing, done in response to learn-
ing tasks, along with a concluding section that reflects on and integrates their
12 The counsellors workbook

learning. This assignment format is an excellent way to encourage student


initiative and creativity, since they will all choose different combinations of
learning tasks, and all their answers are, inevitably, original (there is nowhere
that they could find the answer to a learning task already written in a book or
article the only answer is their personal one). One highly challenging variant
on the portfolio assessment option is to ask students to edit and integrate their
pieces of writing into a statement of their personal philosophy of counselling/
psychotherapy.
Building on life
experience: the
foundations of a
personal approach

Section contents
Introduction 15
Writing your autobiography: getting started 17
Keeping a personal journal 18
The story of a helping relationship 19
The origins and development of your interest in therapy 20
Your favourite story 21
The self puzzle 23
Thickening your autobiography: early memories 24
An inquiry into sexuality 25
Your personal experience of therapy 26
What you bring to counselling 27
Exploring cultural identity 29
Feeling really understood 31
Mapping your relationship patterns 33
Engaging with difference 34
How do you cope with crisis in your own life? 36
The experience of changing your own behaviour 37
The role of therapy in your life story 38
Knowing how your emotions are organized 40
What is your psychopathology? 42
How relevant is spirituality? 43
How do you cope under pressure? 44
Do you have a preferred learning style? 45
What motivates you? 47
Reflecting on the experience of writing about yourself 48

13
15

Introduction

This section of the Workbook contains a series of tasks that invite you to write about
various aspects of your own life. To be a counsellor or psychotherapist involves
being able to draw on your own experience, as a means of relating to the people
you are trying to help. Your own life story therefore becomes a resource, within
which you can find meaning in response to the issues presented by those who visit
you for help.
The writing tasks in this chapter serve two purposes, in relation to developing
therapeutic competence. First, they require you to explore both difficult and hidden,
and also joyful, moments in your own life. They are intended to encourage you to look
at yourself in terms of certain key questions:
G What are my strengths and gifts in connection with the task of being a
therapist?
G What are my areas of vulnerability or uncertainty in relation to the activity of coun-
selling/psychotherapy?
G What is my own personal understanding, arising from my life experience, of
core therapeutic processes such as initiating and maintaining change, sus-
taining satisfying relationships with others, and taking account of the ways in
which my childhood and cultural environment have shaped my behaviour and
identity?
By writing openly, honestly and in detail about your life, you can begin to build what
narrative therapists call a thick description of your identity as a counsellor: thin
description allows little space for the complexities and contradictions of life. . . . It
allows little space for people to articulate their own particular meanings of their actions
and the context within which they occurred (Morgan, 2000: 12). By contrast, a
thick story is one that is richly described, in which the intricacy of ones story, and the
way it interlocks with the stories of other people, is expressed. A thick story
encompasses multiple possibilities, in terms of what it says about the persons capacity
to act and feel.
Second, several exercises in later sections of the Workbook make reference to the
writing tasks in this chapter. You will be invited to reflect on what you have written here
from a range of theoretical and practical perspectives. It is a good idea, therefore, to
begin your use of the Workbook by spending some time writing in response to at least
four or five of the activities in this section, before moving on to tackle any of the
activities in other sections.
All these writing tasks present substantial challenges. It would not be realistic, or
possible, to attempt all of them at one sitting. Some of these pieces of writing may be
best tackled in short sections, adding new material on different occasions. It is possible
that some of the writing tasks open up areas of memory and experience that are painful
or unresolved. It may be right for you to wait until the right moment before embarking
on these pieces of writing.
16 The counsellors workbook

In any personal writing of this type, it can be helpful to create your own rituals and
space within which you feel free to express yourself. Before you begin, you might wish
to think about where and when would be the best time and place for you to do this kind
of work.
17

Writing your autobiography:


getting started

The purpose of this activity is to give you an opportunity to sketch the story of your life
your autobiography in outline form. Being able to develop an understanding of your
own development over time, and the ways in which you have responded to different
external situations and demands, can represent an invaluable resource for a therapist.
Biographical self-awareness can help to provide you with a means of understanding
your own reactions to clients, and of empathizing with the experiences and dilemmas
that clients describe in relation to their own lives.

Instructions
Spend some time thinking about your life its past, present and future. Imagine your life
is like a book, with each of the major parts or stages comprising a chapter. Provide titles
for each of the chapters, and describe the content of each in a little more detail.
What is the underlying theme of the book? Can you find a title for the story as a
whole?
Feel free to add anything else that seems relevant to constructing a framework for
your autobiography. For example, there may be photographs, objects or pieces of music
that represent significant memories. Remember the purpose of this task is to facilitate
your learning go with what feels right for you.
As you are writing your autobiography, reflect on how it feels to write about yourself
in this way. Are there some memories that are painful, which you would rather avoid?
Are there other memories that are joyful and self-affirming?
You may find that, once you have started to write your autobiography, further epi-
sodes, scenes and themes come to mind. It may be valuable to add these to what you
have written, so that you gradually build a more complete story of your life. It can often
be useful to return to what you have written months or years later, and reflect on the
ways in which you have rewritten your personal history.

Further reading
This activity draws on the work of the narrative psychologist Dan McAdams:
McAdams, D.P. (1993) The Stories We Live By: Personal Myths and the Making of the Self. New
York: William Murrow.
McAdams, D.P. (2000) The Person: An Integrated Introduction, 3rd edn. New York: Wiley.
18

Keeping a personal
learning journal

Many counselling and psychotherapy courses require students to keep personal learn-
ing diaries or journals, as a means of reflecting on experience, and integrating theory
and practice. A learning journal also makes it possible to keep track of personal change
and development, and to keep hold of new insights (by writing them down) rather
than losing them through forgetting. There is evidence that writing can in itself be
therapeutic (at some point in the future you may want to suggest to some of your
counselling clients that they might want to keep a personal journal). Learning how to
use a learning journal can be viewed as an opportunity to gain first-hand experience of
a powerful therapeutic tool.
Some suggestions for how to keep a learning journal:
1 Choose a medium that is right for you. This could be a notebook, a ring binder
that you can add pages to, or a wordprocessor folder.
2 Keep it safe. You will not want other people to see what you have written unless
you ask them to. Find a way of maintaining your privacy.
3 Date each entry in the journal and give it a title. This will help you to make sense
of what you have written when you read it later.
4 Write quickly, as if you are allowing your stream of consciousness to flow on to
the page. Try not to censor what you write. Do not worry about spelling, punctu-
ation or grammar what you are writing is just for you.
5 Experiment with different ways of writing. Sometimes it is useful to write a list of
ideas or images rather than attempting to produce continuous prose. Sometimes it
may be helpful to draw pictures, use coloured pens, or construct diagrams.
6 Some people find it helpful to get into a routine or ritual where they write their
journal at a particular time and place each day.
7 Other people find it helpful to keep notebooks or scraps of paper with them so
that they can note down flashes or sudden ideas and insights.
8 A learning journal is not a personal diary. It is focused on your involvement with
the roles, tasks and challenges of being or becoming a therapist.

Further reading
Adams, K. (1990) Journal to the Self. New York: Warner Books.
Rainer, T. (1978) The New Diary. London: Angus and Robertson.
Rainer, T. (1997) Your Life as Story: Writing the New Autobiography. New York: G.P. Putnam.
Thompson, K. (2004) Journal writing as a therapeutic tool, in G. Bolton, S. Howlett, C. Lago
and J. Wright (eds) Writing Cures: An introductory Handbook of Writing in Counselling and
Psychotherapy. London: Brunner-Routledge.
19

The story of a helping


relationship

If you are to build on your own experience, then it is important to be aware of your own
strengths and gifts in counselling situations. The aim of this exercise is to give you an
opportunity to begin to reflect on what you already know, in relation to counselling
what are the skills and areas of awareness that you already possess?
This task requires writing about an occasion in which you were involved in a helping
relationship with someone. The person you were helping could have been a counsel-
ling client, or equally well may have been a friend or family member. The helping
relationship may be a formal one, in the context of your work, or an informal one, in the
context of family or friends. Your task is to write an account of what happened when
you helped this person. You should cover such points as:
G What led up to the helping incident, what was the background to you being
involved with the person in this way?
G What were your aims, what did you want to accomplish?
G What did you say and do?
G What was going on in your mind at every stage of the process?
G What did you feel about what you were doing?
G What was the outcome how did it all end?
Your account of this incident should have a beginning, a middle and an end. Keep it
descriptive of what actually happened and what you actually did and felt there is no
need to interpret or explain your actions for the purpose of the exercise. It is best if you
choose an incident to write about where you felt you were reasonably successful in
what you were trying to achieve. Do not include any identifying characteristics of the
person being helped. Change their name and any other possible identifying features,
just in case anyone else reads what you have written.
The event you select should be a reasonably complex incident, something that lets
you express and explore your capacity to help. You can write as much or as little as
seems right to you, but aim to reach at least 500 words. Give your story a title.
Later exercises in the Workbook invite you to look at what you have written from a
variety of different theoretical perspectives.

Further reading
Combs, A.W. (1986) What makes a good helper? Person-Centered Review, 1: 5161.
Combs, A.W. (1989) A Theory of Therapy: Guidelines for Counselling Practice. London: Sage.
20

The origins and


development of your interest
in therapy
This learning task gives you an opportunity to explore the roots in your life experience
of what it means to you to be a counsellor or psychotherapist.

Instructions
Imagine yourself some time in the future, when you are established in your career as a
counsellor or psychotherapist. Imagine that you are in your therapy room. It is your
ideal counselling room, furnished and decorated to create an optimal working environ-
ment for you. Look around it what do you see? What is this room like? Now, imagine
that three or four of your closest professional colleagues or friends are coming to visit
you in this room. These are people who really know you, who understand and accept
you. Who are they? Welcome them. They have come for a special reason, to hear you
tell your story of how you became a therapist. Think about becoming a therapist as a
journey. Start right at the beginning of that journey. Tell them about your earliest experi-
ences in family and school that somehow seem connected to your choice of becoming
a therapist. Describe the people, places, relationships and events that have influenced
you in the direction of counselling. Identify the choice points, where you made
decisions to commit yourself more fully to this type of work. Bring the story up to date.
Tell them where you have arrived on your counselling journey.
You may find it useful to close your eyes for a few minutes and imagine telling this
story. Then write it down. Try to write in as much detail as you can. Write quickly do
not censor what you put down. You may find that there are other bits of your story that
occur to you over the next few days add these in later. Remember, this is your personal
story. There are no right or wrong answers, and no one will see what you have written,
unless you invite them to.

Further reading
You may find it helpful to think about the story you have written in terms of the section on the
counsellors journey in:
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(pp. 61417).
To what extent do you think that this model can help you to make sense of your experience
of becoming a counsellor or psychotherapist?
21

Your favourite story

Most of us have a story that, somehow, has a special appeal to us. This learning activity
invites you to identify, then write down, your favourite story, and then reflect on what
you have written in terms of a series of prompt questions.

Identifying your favourite story


G What is your favourite story? This could be a fairy tale, novel, short story, play, film,
TV show, and so on. It may be a story that you always treasured, and returned to at
different points in your life, or it could be the first story that came to mind when
you started to read these instructions.
G Write the story in your own words. It does not matter whether your version is
different from the original what matters is the story as you recall it. Write the story
in as much vivid detail as you can, from beginning to end.
G If you have more than one favourite story, complete this exercise at another time,
in relation to one or more further stories.

Exploring the personal meaning of your favourite story


Slowly read through the story you have written, and make notes in response to the
following questions:
G Who is your favourite character in the story?
G Why do you like this character so much?
G What happens to this character?
G Who are the other characters? What kind of relationship does your favourite
character have with these other characters?
G What is the setting for the story? Where does it take place?
G What is the main feeling tone of the story?
G How does the story end? How do you feel about the ending? If you could change
the ending, what would your preferred ending be like?
G When did you first come across this story? How often, and in what ways, do you
refresh your acquaintance with this story?
G Why do you like this particular story? Why do you think that you chose it?
Your responses to these questions may suggest further details of the story add these in
to your written version as you go along.
22 The counsellors workbook

Finally give yourself some time to reflect on what you have learned about yourself
from this process.
Some suggestions for exploring the meaning of stories, such as a favourite story,
are provided in the learning activity Making sense of stories, in Section 5 of the
Workbook.
23

The self puzzle

Most approaches to therapy emphasize the importance, in one way or another, of the
persons sense of self. The notion of an individual self, as the core of who a person feels
him or herself to be, lies at the heart of counselling and psychotherapy.
There are many different ways of understanding or picturing the self. Sigmund Freud,
for example, portrayed the self as similar to an iceberg, with the largest part beneath the
surface.
In order to engage with a clients sense of self, it is usual to have an appreciation of
your own sense of self. This activity introduces a simple method for beginning to
explore the way that the self is structured and organized.
The exercise requires access to coloured pens or crayons, and a piece of blank paper
(a large piece of paper is best). The task is to draw a map or puzzle to represent the way
you view your self following these guidelines:
In some ways everyone is a puzzle, consisting of many different parts.
You are a puzzle with parts that are unique to you. Draw a puzzle with
parts that are labelled that best describe you, as you see yourself now.
The number of parts, the shape of the parts, and the positioning of the
parts are all up to you. They should, however, be used to represent your-
self as descriptively as possible. There are no right and wrong answers.
This self puzzle is your own creation take as long as you wish to com-
plete it. An alternative way of thinking about this creation is to look at it
as a map. Similarly, the map of how you see yourself now will include
areas that are labelled.
Be aware of the thoughts and feelings that accompany this task as you construct your
puzzle or map. After you have made your drawing, it may be helpful to write some
notes about these thoughts and feelings, and also of what you have learned about
yourself through engaging in this activity.
Once you have completed this exercise, you may find it useful to turn to the Making
sense of self learning task in Section 3 of the Workbook, which includes some guide-
lines for interpreting your self puzzle picture. It can be valuable to repeat the self puzzle
on different occasions, to explore how your sense of self is affected by different contexts
and life experiences.

Further reading
The idea of the self puzzle has been adapted from:
Loo, C.M. (1974) The self-puzzle: a diagnostic and therapeutic tool, Journal of Personality, 42:
23642.
24

Thickening your
autobiography: early
memories
This exercise provides an opportunity to carry out some further exploration around the
complexity and richness of your understanding of who you are your autobiography.
Many clients who seek therapy can be viewed as engaged in a struggle to achieve a
coherent appreciation of many different, and often difficult, strands of their life experi-
ence. To be able to facilitate this kind of meaning-making, it is invaluable to have
undergone such a process yourself.
Early memories can often represent a highly significant source of meaning in a
persons life. Take some time to identify, then write down, your earliest memories.
Describe the memories in as much detail as possible. Begin by going back to your
childhood and try to recall your earliest childhood memory. Try to recall a specific
incident or event, not just a fragmentary impression. What are your impressions of
yourself, and of each of the other people in the memory? Describe, also, the mood or
feeling tone that goes with this memory.
Once you have written about your earliest memory, you may find it useful to explore
other early memories; for example, your first memory of your mother, father, siblings or
other family members, or memories of moments that were high points, or formative
turning points, in your life.
When reflecting on what you have written about your early memories, it is help-
ful to ask yourself whether the patterns of needs, relationships and emotions that are
represented in these stories have persisted as themes in your life.

Further reading
The importance of early memories was first recognized by Alfred Adler, one of Freuds inner circle.
The specific early memory instructions used in this exercise are derived from research carried out
by Martin Mayman and his colleagues. Further information on these studies can be found in:
Fowler, J.C., Hilsenroth, M.J. and Handler, L. (2000) Martin Maymans early memories technique:
bridging the gap between personality assessment and psychotherapy, Journal of Personality
Assessment, 75: 1832.
Many other researchers and therapists have explored the notion that early memories convey, in
summary form, the key existential themes that influence the directions of a persons life.
Clark, A. (2002) Early Recollections: Theory and Practice in Counseling and Psychotherapy.
New York: Brunner-Routledge.
Csikzentmihalyi, M. and Beattie, O. (1979) Life themes: a theoretical and empirical exploration of
their origins and effects, Journal of Humanistic Psychology, 19: 4563.
McAdams, D.P., Hoffman, B.J., Day, R. and Mansfield, E.D. (1996) Themes of agency and
communion in significant autobiographical scenes, Journal of Personality, 64: 33977.
25

An inquiry into sexuality

The meaning and importance of sexuality is a topic that therapists need to be able to
explore with clients. The aim of this activity is to provide a structure within which your
experience of sexuality can be explored, and the implications for your approach to
counselling/psychotherapy can be identified.
Over the next two or three days, give yourself some time to engage in an inquiry into
your sexuality. The following suggestions may help to get you started:
1 How has your sexuality developed? Draw a timeline, stretching from birth to the
present, and enter the key events and stages/phases in the growth of your sexual
awareness and behaviour.
2 Where does sexuality fit into your life? What part does it play? How do you use
your sexual awareness and energy?
3 What are your attitudes and feelings in relation to people whose sexual orienta-
tion and behaviour differs from your own?
4 Describe how you have dealt with (or anticipate that you would deal with) a
counselling relationship where:
a You felt sexually attracted to the person you were helping.
b The person you were helping expressed sexual attraction toward you.
c How did you (or might you) respond in each case?
5 How would you react to a client who asked you to help him or her make sense of,
and resolve, a sexual problem? Which sexual problems would you feel more/less
confident in working with? What would you do if you did not feel confident or
competent to work with the client in the way that he or she had requested?
6 How did you feel about reflecting on these questions, writing about them, and
perhaps discussing them in a group? What does this response tell you about your
position in relation to sex and sexuality?
Once you have written and reflected around these questions (and possibly around other
questions or themes that may have struck you as interesting in this area), shift to
consideration of the implications of what you have discovered for your sense of who
you are as a therapist. For example, in what areas do you feel that you need to acquire
more knowledge about sex and sexuality?

Further reading
Denman, C. (2003) Sexuality: A Biopsychosocial Approach. London: Palgrave Macmillan.
Hudson-Allez, G. (2005) Sex and Sexuality: Questions and Answers for Counsellors and Therapists.
Oxford: Wiley-Blackwell.
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(pp. 47481).
26

Your personal experience


of therapy

One of the consistent themes in all approaches to counsellor and psychotherapist train-
ing is that it is important for helpers to know what it is like to be the recipient of help.
The aim of this activity is to encourage you to focus on your experience of being helped,
and to reflect on the implications of that experience for your understanding of the
helping process.

Instructions
What is your own personal experience of receiving counselling, either on a formal,
contracted basis or informally from a friend, teacher or priest (or anyone else who is not
a member of your immediate family)? Write a brief account of one useful or successful
counselling encounter that you have experienced. Make sure you write your story in a
place that is private and confidential, so you can be as open and honest as possible.
You may find the following questions useful in terms of structuring your account:
G What was troubling you?
G At what stage of your life did this trouble emerge?
G What made you seek help, or be open to receiving help, at this particular point?
G How did you make contact with this helper?
G What happened during the counselling or helping session or sessions?
G What were the most useful things your counsellor did?
G Was there anything unhelpful that he or she did?
G How did this counselling help you; what was the longer-term impact on you?
Next, if possible, write a parallel account of a counselling/helping episode (again,
where you were the recipient of help) that was not helpful.
After you have written an account of your experience, take some further time to
write about what you have learned.

Further reading
Geller, J.D., Norcross, J.C. and Orlinsky, D.E. (eds) (2005) The Psychotherapists own Psycho-
therapy: Patient and Clinician Perspectives. New York: Oxford University Press.
27

What you bring to


counselling

For many people, the decision to become a counsellor or psychotherapist may follow a
period of time studying, and working in, another profession or discipline, such as nurs-
ing, social work, teaching, the ministry or psychology. These early career activities may
shape the way that people are viewed, and helping or therapy are understood. Some
trainees or students on counselling courses find that, at the beginning of their training,
they have a tendency to look at issues through the lens or perspective of their primary
profession. Others may be so highly motivated to leave their primary profession behind
that they deny its relevance to their work as a counsellor.
This learning task invites you to reflect on what you bring to counselling, in terms of
previous knowledge, skills and experience. The following questions are intended to
focus your exploration of this issue:
1 Divide a page into two columns. In the left column, list all the potential areas of
your life experience that may be sources of knowledge, skills and experience that
are relevant to counselling. These could be jobs you have done (e.g. worked as an
emergency room nurse for two years) or they could be linked to your family or
personal life (e.g. my mother and father divorced when I was 10 years old).
2 In the right column, list the knowledge, skills and experience that you acquired as
a result of the life experiences that you have identified. For example, working as
an emergency room nurse may have helped you to understand how people
behave in crisis and to talk openly about death. The divorce of your parents may
have enabled you to be sensitive to the effect that loss of attachments in child-
hood can have on the rest of a persons life.
3 What have you brought with you from your previous experience that might be a
strength or asset in relation to your work as a counsellor?
4 What have you brought with you that might be a hindrance or distraction?
Examples: the nurse part of me wants to solve peoples problems for them,
studying academic psychology encouraged me to be objective and detached,
rather than empathic.
5 Some people find that counselling training seems to cut them off from what they
already knew, in a practical sense, about helping others. Michael White (1997:
13) has described this process in these terms:
. . . entry into the culture of psychotherapy is associated with an
induction in which the more local or folk knowledges that have been
generated in a persons history are marginalised, often disqualified,
and displaced by the formal and expert knowledges of the profes-
sional disciplines, and by a shift in what counts in regard to the
significant memberships of a persons life. In this process the mono-
culture of psychotherapy is substituted for the diverse, historical and
local associations of persons lives.
28 The counsellors workbook

To what extent have you been aware of this process taking place with respect to your
own involvement in counselling training and practice? In what ways has therapy train-
ing moved you away from people and modes of helping within your family and
community?
In order to make sense of the reflections and memories that have emerged during
these activities, it may be valuable to consider that becoming a counsellor or psycho-
therapist can be viewed as a journey, which takes several years and on which many
challenges must be faced. The questions above can help you to answer the question:
What are the tools and skills that you take with you on this journey, and how best
can you use them?

Further reading
The experiences of counsellors and psychotherapists who have found ways to use their earlier
work and study (in a wide range of professions and disciplines) to inform their therapy practice are
described in:
Thorne, B. and Dryden, W. (eds) (1993) Counselling: Interdisciplinary Perspectives. Buckingham:
Open University Press.
The narrative therapist, Michael White, has argued forcefully that it is essential for therapists
to remain in touch with the everyday life roots of their capacity to care for others:
White, M. (1997) Narratives of Therapists Lives. Adelaide: Dulwich Centre Publications.
29

Exploring cultural identity

A sense of personal identity and belonging, of values and image of the good life, is
rooted in the culture in which we live. When we meet someone else, we immediately
begin to decode all the cues relating to their cultural position social class, gender,
ethnicity, race, religion, sexual orientation, political affiliation, and so on. At the same
time, the other person is doing the same with us.
In counselling, it is necessary to be aware of the various strands of your cultural
identity. This helps you to:
G be aware of the kind of impact you might be having on the other person;
G appreciate the cultural roots of the theory/model you are using;
G be sensitive to and curious about the other persons cultural identity;
G talk about cultural difference when this becomes relevant within the counselling
relationship;
G appreciate the impact of social class, religion and other cultural factors in the life
of the client;
G defuse your fear of the other.
The aim of this learning task is to help you to become aware of your cultural
identity.

Instructions
1 Very quickly, without thinking too much about it, write down a list of your first 20
answers to the question Who am I?. What does this list tell you about your
cultural identity?
2 What are the different sources and strands of your cultural identity? Write out a
genogram, or family tree, indicating beside each person (parents, grandparents,
great grandparents) the information you have about their cultural and social pos-
ition. What does this genogram tell you about your cultural identity: to what
extent are these cultural themes influential in your life now?
3 What kind of cultural exploration have you carried out within your life? What
new cultural influences have you been exposed to, or sought out? Draw a life-
line from birth until now, and indicate on it the significant cultural shifts that you
can recall. For example, have you moved away from, or towards, any of the
cultural traditions represented by people depicted in your genogram? What new
people or institutions have come into your life, bringing different cultural
influences?
30 The counsellors workbook

4 What is the meaning of home for you? Where is the place you belong? (Home
can be imaginary or real.)
Finally reflect on, and write about, what you have learned about your cultural identity.
How might you describe and sum up your cultural identity if you were invited to work
with a group of colleagues from another culture?
31

Feeling really understood

At the heart of counselling is the hope that someone else can accept and understood us
for who we are, without judgement or analysis. The aim of this exercise is to encourage
you to explore the significance, in your own life, of this type of moment.

Instructions
Part 1
Sit quietly for a few seconds. . . .
Think about the last time you felt really accepted and understood by another person.
Once you have identified such an occasion, you should briefly describe (on a piece
of paper):
G what the circumstances were;
G how you felt;
G what the consequences or effects of being accepted and being understood were.
Following this piece of writing, take some time to reflect on the implications of the
experience of being understood for your understanding of your relationships with other
people.

Part 2
Take another few moments to reflect on the people who have understood you at various
points in your life. Who were these people? How did they express their understanding?
What impact did their understanding and acceptance have on your development
as a person?

Part 3
Allow yourself some further reflection on your experience of being with people
who did not understand and accept you at different points in your life. What impact
did their conditional stance in relation to you have on the way that you felt about
yourself?
Finally write in your personal learning journal about these experiences, and their
implications for your approach as a counsellor. How important is it to you to offer your
clients an experience of being understood?
32 The counsellors workbook

Further reading
A research study that has analysed the experience of being understood is:
Bachelor, A. (1988) How clients perceive therapist empathy: a content analysis of received
empathy, Psychotherapy, 25: 22740.
You may find it interesting to look at how your own experience compares with what was reported
by participants in this investigation.
33

Mapping your
relationship patterns

The aim of this activity is to give you an opportunity to explore the different types of
relationship you have had with other people at various times in your life.
Take some pens and blank pieces of paper and make some simple diagrams that
map out your relationships with the people who have been important to you at different
stages in your life. It is best to draw each diagram on a separate piece of paper. In the
middle of the page, you should draw a circle to represent yourself. Write me or your
name inside this circle. Around yourself, you should arrange the people who were
important for you at that point in your life. The distance from you on the page should be
used to represent their emotional, psychological or inner presence for you, rather than
who was physically there, how far away they lived, or similar factors.
What you will end up with is like a map of the planets, with a set of circles around a
central star. Label each circle with the name of the person who belongs there.
There are two additional kinds of circle that you might find yourself wanting to draw.
One is a dotted circle to indicate someone who mattered a lot to you at that time of
your life but who was not there at all as a physical presence. This might be someone
who you talked to in your head or thought about a lot even though you had no
real connection with him or her at that time. Another kind of circle you might like to
draw is a group circle. This you might draw to indicate people who were important as
a group but did not really matter as individuals. This might be important, for instance, if
you wanted to indicate the importance of a sports team or church group or something
like that.
Draw these diagrams starting at age five, then at 10-year intervals up to the present.
Imagine yourself at age five; try to fix yourself in time, and then pretend to interview
yourself, asking about who is in your mind at that time. Then imagine yourself at age 15,
25, and so on up to your present age.
Once you have completed your diagrams, reflect on the following questions:
G Were there any moments during this activity when you had an emotional
response? What do you think these feelings might mean?
G Were there any recurring themes or patterns that emerged, around the types of
relationship you have had over your life? What were these themes or patterns?
G What might be some of the implications of your relationship style for your work as
a counsellor? How might the ways of relating that run through your life have an
impact on your counselling? What kinds of relationship are you more likely to have
with clients, colleagues, tutors/trainers and supervisors?
This activity is adapted from Josselson (1996), a book that also provides a very useful
framework for making sense of relationship patterns.
34

Engaging with difference

As a counsellor, you may have little choice in relation to the characteristics of the
people who use your service. Many people who seek your help will undoubtedly be
easy to like, understandable, admirable. These are people with whom you may feel
comfortable, and enjoy an easy rapport.
But there will be some service users who, for you, are difficult. These are people
who make you feel far from comfortable, in whose presence you feel threatened, on
edge, lost.
The purpose of this exercise is to explore the theme of difference in your life. Give
yourself some time to reflect on, and write about, your responses to the following
questions:
G Which groups of people do you regard as being most different from you? Make
a list.
G Beside each group, write a set of adjectives that you might use to describe what
they are like.
G Generate another set of adjectives to capture how you would imagine you might
feel in the presence of a member of this group.
G What are the sources of your information about each of these groups of people?
How much of your information is first hand, arising from personal contact, and
how much from other sources? How much curiosity do you have about each of
these groups?
Looking at what you have written, can you identify any themes in your responses? What
lies at the heart of difference for you? Is difference a matter of values, gender, social
class, race, physical appearance . . .? What is it that makes someone different? Can you
make connections between these meanings of difference for you and other aspects of
your biography?
In relation to your work as a counsellor, imagine for a few moments who your least
preferred client might be. How would you react, and what would you do if this client
walked into your counselling room?
Finally: what is your personal experience of being different? What are the situations
in your own life in which you have felt as though you did not fit in, were not accepted
by others, or did not know the rules? What are your strategies for coping with such
situations? How can you use your own experience of being different to inform your
work as a counsellor?
Building on life experience 35

Further reading
The essential role of curiosity in dissolving difference is discussed in:
Dyche, L. and Zayas, L.H. (1995) The value of curiosity and naivet for the cross-cultural
psychotherapist, Family Process, 34: 38999.
A valuable collection of papers on the theme of identity and difference in therapy is:
McGoldrick, M. (ed.) (1998a) Re-visioning Family Therapy: Race, Culture and Gender in Clinical
Practice. New York: Guilford Press.
36

How do you cope with


crisis in your own life?

The majority of people who use counselling do so in response to an immediate crisis.


Even if a person has lived with difficulties for a considerable time, there is typically a
particular event that triggers the decision to seek outside help. In order to appreciate
what a person might be experiencing when they contact a counselling agency with a
problem, it is useful to reflect on your own personal experience of crisis.

Instructions
Write about your experience of a crisis in your own life within the framework provided
by the following questions:
G Briefly describe an episode in your life when you felt that you had reached a real
crisis point as a result of a problem such as: work pressure; the demands on you as
a carer; feeling depressed or hopeless; feeling really worried; feeling panic in
particular situations; feeling traumatized after an accident or assault, and so on.
G How was your capacity to cope affected during the worst points in this episode?
Briefly describe the impact of the situation on your capacity to make decisions,
take care of yourself, control your emotions, and think straight?
G What helped you to get through this? Describe how you used both your own
personal resources (e.g. humour, courage, spirituality) and other people to help
you to cope?
G How long did it take you to work through this crisis?
G What was the most difficult aspect of the crisis?
G What helped you most?
G What have you learned about yourself, and other people, as a result of this event?
G How have you changed?
G What have you learned, from your responses to these questions, that is relevant for
your counselling practice?

Further reading
James, R. and Gilliland, B. (2001) Crisis Intervention Strategies, 4th edn. Belmont, CA: Wadsworth.
Kanel, K. (1999) A Guide to Crisis Intervention. Belmont, CA: Wadsworth.
37

The experience of changing


your own behaviour

Think of an occasion when you were able to change your own behaviour in what you
considered to be a positive direction. This should be an occasion when you intention-
ally planned to make a change in your behaviour, and carried it through to completion.
If it is not possible for you to identify a time when you were successful in changing your
behaviour, then write about an episode in which you made an attempt to do so.

Instructions
Take a few moments to identify an unwanted habit or behaviour pattern that you have
managed to eliminate or minimize in your life, or to establish a new pattern. The
unwanted behaviour could be something like smoking, eating chocolate, arguing, being
late . . . anything that you have wanted to change in yourself. A desired new behaviour
could be something like taking more exercise, spending quality time with your family,
or tidying up your room.
Describe what happened:
G What was the behaviour you decided to change?
G Why was this pattern of behaviour a problem for you?
G Had you tried unsuccessfully to change this habit before? Why had you been
unsuccessful?
G What did you do to enable the change to take place this time?
G What helped you in making these changes?
G What hindered you?
G Did you experience any setbacks or relapses? How did you overcome them?
G What did you learn about yourself, and about how you would set about changing
things in your life if you need to again in the future?
G Have there been other change events in your life that have followed a different
pattern, or is the event that you have described typical of how change happens in
your life?
Finally, reflect on what you have written in relation to the following questions:
G What are the implications of the episode you have described here for the way in
which you understand change to take place in counselling/psychotherapy?
G To what extent does your experience of changing your behaviour generalize to a
counselling/psychotherapy situation?
G Which theories of therapy help you to make sense of the change process that you
experienced?
38

The role of therapy in your


life story

People who seek counselling or psychotherapy are often stuck at a point of choice in
their lives, faced with a dilemma over choices to make. To appreciate what this is like, it
is helpful to be able to draw on an understanding of your own experience of making
important life choices.

Instructions
Take a blank sheet of paper and a pen.
Starting with the year of your birth, draw a line to the first choice juncture that you
can think of. Show how the path forks, giving you a number of alternatives. Which path
did you take? Make sure you indicate the paths not taken, as well as the one that you did
take. The choices should be ones that had an important effect on your life. When you
have finished with one choice point, go on to the next one. Note your age at each
choice point, and give each of the paths (taken and untaken) a brief label. Continue
until you reach your present age.
Figure 1.1 provides an illustration of the kind of choice map that you might generate:

FIGURE 1.1 My life choices, Andy Simpson, August 2003


Building on life experience 39

Reflecting on your choice map


Looking at your map as a whole, what patterns and themes do you see? Is there any
consistency to the paths you have not chosen?
What has your involvement with therapy been around these choice points in your
life? To what extent, and in what ways, has therapy facilitated your life decisions?

Further reading
The choices in life exercise have been adapted from the following article:
Lewchanin, S. and Zubrod, L.A. (2001) Choices in life: a clinical tool for facilitating midlife
review, Journal of Adult Development, 8: 1936.
40

Knowing how your


emotions are organized

The fundamental issue that drives most people to seek therapy is that they feel bad
there is some aspect of their emotional life that feels out of control, unmanageably
painful, or shameful. Often, when a person commences therapy, he or she may spend
a lot of time rationalizing about what is the matter. Behind this talking and thinking,
there remains the same emotional struggle. All approaches to therapy, in their different
styles, enjoin therapists to pay attention to the clients pattern of feeling and emotion,
and to take these emotions seriously. In order to be able to do this with any degree of
confidence and success, it is necessary for anyone who practises counselling or psycho-
therapy to be aware, at a personal level, of how their own feelings and emotions are
organized, and what they mean. This exercise is intended to facilitate self-exploration of
personal emotional patterns.
Slowly read the following story to yourself:
Imagine that you are on your way to an important family occasion, a wedding
that is being held in another country. In the run up to your trip to the wedding,
you have been extremely busy. As a result, the other members of your family
who are closest to you (e.g. your partner and/or children) have travelled in
advance. You are booked on to the very last flight that will convey you to the city
where the wedding is taking place on time. It is a holiday weekend, and many
people have decided to take flights to foreign destinations. You know that the
road to the airport will be busy, so you leave yourself plenty of time. However,
there is an accident ahead of you on the road, and you are completely stuck
in a traffic jam for over an hour. By the time you have arrived at the airport,
parked your car, and run to the departure hall, it is too late to check in. Even
though you have arrived at the check-in at least 30 minutes before the flight is due
to board, the staff absolutely will not let you go through. They insist that all
passengers must check in 45 minutes before the boarding time. All the other
flights to your destination, or to cities that are near to your destination, are full.
There is no way that you will be able to attend this important event that means so
much to you.
As you realize what has happened, how do you feel? Give a name to that emotion.
Reflect on the following questions:
G Is this feeling or emotion one that you typically experience in stressful situations?
G To what extent did this emotion or feeling make a contribution towards resolving
your problem (at the check-in desk or in other situations in your life)? How func-
tional is it?
G Is it a pattern of feeling or emotion that was particularly encouraged or rewarded in
your family while you were growing up?
This exercise is adapted from Stewart and Joines (1987: Chapter 21), and is linked to the
Building on life experience 41

TA model of emotional rackets. However, it can also be used to explore other models
of emotional functioning (see, for example, Greenberg, 2002a).
What have you learned about yourself from this exercise? What are the implica-
tions of this learning in relation to how you respond to your clients around emotional
issues?
42

What is your
psychopathology?

Everyone has a core issue that they struggle with throughout their life. The psycho-
analyst, Michael Balint, called this the basic fault. For one person, the struggle may
be around fighting off hopelessness, despair and depression. For another person, their
life may be organized around controlling their fear of other people intruding on their
boundaries. For a third person, the struggle may be around feeling loved and having a
sense of being important to others.
The aim of this learning task is to give you an opportunity to reflect on your own
enduring personal struggle. Take some time to reflect on, and write about, your responses
to the following questions:
1 What is your own core issue or area of psychopathology? What is the pattern of
thinking, feeling and action that gets you into trouble, or consistently undermines
your life goals?
2 In terms of well-known models of psychopathology, would you describe yourself
as schizoid, obsessional or personality disordered (or as having a tendency in any
of these directions)?
3 Where does this pattern come from? How did this area of difficulty arise in your life?
4 What do you do to cope with this issue, or to manage it? Have you used different
strategies at different points in your life? What strategies have been most and least
effective?
5 Who knows about your basic fault? How open or secretive are you around this
issue? What might it be like for you (or has it been like for you) to talk about this
topic in your personal development group, or in other contexts?
6 How do you make sense of this key life dilemma or challenge? What models or
theories have you found helpful (or unhelpful) in enabling you to understand,
accept and resolve this issue?
7 What are the implications of your psychopathology, and your way of understand-
ing it, for your work as a therapist?

Further reading
An accessible introduction to the meaning of concepts such as schizoid and obsessional can be
found in:
Joines, V. and Stewart, I. (2002) Personality Adaptations. Nottingham: Lifespace.
Essential reading on patterns of personality disorder is:
Benjamin, L.S. (2003) Interpersonal Diagnosis and Treatment of Personality Disorders, 2nd edn.
New York: Guilford Press.
43

How relevant
is spirituality?

The emergence of counselling and psychotherapy in the mid-twentieth century, as


widely available forms of psychological care, was associated with an emphasis on
a rational, scientific worldview that allowed little place for spirituality and religious
experience.
However, more recently, influential figures in the therapy profession have called for
a reintegration of spiritual experience into counselling theory and practice:
Our experiences in therapy, and in groups, it is clear, involve the tran-
scendent, the indescribable, the spiritual. I am compelled to believe that
I, like many others, have under-estimated the importance of this mystical,
spiritual realm.
Rogers (1980)
My own belief . . . is that anyone who wants to be a good psychotherapist
has to have their own spiritual discipline which they follow.
Rowan (1993)
What place does spirituality have within your approach as a counsellor? Consider the
following questions:
1 What is your relationship with spirituality? What does spirituality mean for you?
2 In what ways do you (or might you wish to) draw on spiritual practices (e.g.
prayer, meditation, yoga, reading, use of sacred objects) in preparing yourself for,
or coping with the demands of, counselling work?
3 What types of spiritual experience have you encountered in your life? Have any
of these experiences taken place during counselling, or similar work? What do
you understand these experiences to signify?
4 How do you respond when a counselling client, or a person during an everyday
conversation, starts to talk about the importance of spirituality in their life?
5 Where do spiritual and religious factors fit into your theoretical approach as a
therapist?

Further reading
West, W. (2000) Psychotherapy and Spirituality. London: Sage. (particularly Chapter 1).
44

How do you cope


under pressure?

Being a counsellor requires a capacity to be a companion to other people at their times


of greatest anguish, despair or rage. In arguing for the importance of each counsellor
developing an approach that is firmly based in their own personal way of being, Peter
Lomas has argued that:
. . . the business [of therapy] is to do with finding their own way, using
their own intuition, learning to be themselves in the presence of some-
one who is asking for help, who is probably putting all kinds of pressures
on them.
(Lomas, 1999: 25)
How have you responded in the past when someone with whom you have a relation-
ship of care puts emotional pressure on you? Describe and explore the ways in which
you have responded to the following life events:
G someone who is close to you is terminally ill;
G you are on your own looking after a baby or young child, who will not stop crying;
G you are with a child or teenager who has a tantrum because he or she cannot get
what they want;
G someone you care about has received news of a loss;
G someone you care about is hurt;
G a person in your family has a breakdown, talks in ways that do not make sense,
and declares that he or she is going away to end it all.
These are all very difficult situations that can evoke a wide spectrum of feelings in a
helper or companion. What has your emotional response been in these situations?
What have you done have you moved closer, retreated, withdrawn, displaced your
concern into other behaviour . . .? How has the quality of your connection with the
other person changed or shifted at these moments?
Once you have mapped out your way of reacting to these demanding situations in
everyday life, take some time to reflect on the potential implications of what you have
learned for your work as a counsellor.
45

Do you have a preferred


learning style?

Different people learn in different ways. For example, some people gain more from
reading and individual reflection, while others learn better when actively doing things
with others. The model of experiential learning developed by David Kolb suggests
that the process of learning consists of four phases. For instance, if a person is interested
in learning how to perform a task more effectively, the following processes can be
observed:
G Concrete experience occurs when the person is involved in carrying out a task.
G Reflection on that experience, on a personal basis a process of individual sense-
making.
G Abstract conceptualization is a phase that involves identifying general rules
describing the experience, or the application of known theories to it, which leads
to ideas about ways of modifying the next occurrence of the experience.
G Active experimentation represents the application of these new skills or ideas in
practice, which in turn leads to a new set of concrete experiences, which are then
in turn reflected on. . . .
This sequence of learning steps may take place within a few minutes, or may extend over
months, depending on the topic. Kolb, and other researchers, have noted that although
any competent learner will have a capacity to function in each of these ways, indi-
viduals tend to grow up specializing in one or two preferred learning processes. The
theory of personal learning styles devised by Peter Honey is based on four primary
learning styles, which correspond to the four phases of Kolbs cyclical model:
G Activists involve themselves fully in doing things, enjoy teamwork, and eagerly
embrace opportunities for practical, experiential activities. They are open to new
learning experiences.
G Reflectors prefer to stand back and look at experiences from many different per-
spectives. They collect data and prefer to think about it thoroughly before coming
to any conclusions.
G Theorists adapt and integrate observations into complex but logically sound
theories. They are interested in concepts, and think problems through in a step-by-
step, logical way.
G Pragmatists are keen to try out ideas, theories and techniques to see if they work in
practice. They positively search out new ideas and take the first opportunity to
experiment with applications.
A preference for any one of these learning styles is likely to mean that a person will be
frustrated with learning experiences that are based in a different model. For example,
activists may become impatient with theory and precise instructions, while theorists
may be uncomfortable with the messiness and ambiguity of many practical situations.
46 The counsellors workbook

What are the implications of your learning style for your personal approach as a
counsellor? Consider the following questions:
G How do you define your learning style?
G In what way does your preferred style of learning explain your level of interest
and enthusiasm in different types of learning within your counsellor training
(e.g. reading about theory, participating in a personal development group, being
an observer in skills practice sessions)?
G What are the links between your preferred learning style and the theoretical
approach(es) with which you most identify?
G Could your way of working with clients, within an actual counselling session,
be viewed as an expression of your learning style? Do you create certain kinds of
learning opportunity for clients, and not others?
G How sensitive are you to the learning styles of other people? How well do you
respond to the learning process of clients who have learning styles different from
your own?
G What are the implications of models of learning styles for your capacity to engage
empathically with the experiences of other people?

Further reading
Honey, P. and Mumford, A. (1982) Manual of Learning Styles. London: P. Honey.
Kolb, D.A. (1984) Experiential Learning: Experience as the Source of Learning and Development.
Englewood Cliffs, NJ: Prentice-Hall.
A number of self-test learning styles inventories are available on the Internet.
47

What motivates you?

The list below includes some of the reasons that people give for wanting to be a counsel-
lor or psychotherapist. How important are each of these sources of motivation for you in
your counselling work? Place a 1 beside the most important, 2 for the second most
important, and so on. Add any additional sources of motivation that come to mind.
G Contact with other people (clients) in a controlled situation
G Discovery learning about human beings
G Social status and respect
G Payment, making a living
G Helping or healing others
G Being powerful and having an impact on clients
G Self-therapy, learning about myself through the work
G Vicarious experience, the interest of learning about other peoples lives
G Feeling wanted and needed
G Because I received therapy myself and want to give something back
G Doing a job that is intellectually challenging
G Other sources of motivation not included in the above list
Once you have rank ordered these sources of motivation, consider the following
questions:
G How open are you with other people, such as colleagues, about your motivation to
do this work? There may be sources of motivation that you conceal for others
what difference would it make to own up to these factors?
G How do these sources of motivation/satisfaction influence and shape the way you
work; for example, the decisions you make about the kind of work that you do?
G How have you acquired these motives where do they come from in your life? For
example, are there experiences in childhood, or significant people you have met,
that you can recognize as representing the origins of these motives?
G In what ways have the sources of motivation and satisfaction associated with your
work as a therapist changed over the course of your training or career? What has
triggered these shifts?
G How sustainable are these factors? Can you anticipate any of them becoming less
motivating for you in the future? What would you do if this happened?

Further reading
The issue of therapist motivation is discussed on page 615 of McLeod, J. (2009) An Introduction to
Counselling, 4th edn. Maidenhead: Open University Press.
48

Reflecting on the
experience of writing
about yourself

The activities in this section of The Counsellors Workbook have invited you to write
about many different aspects of your personal life. The technique of personal writing
has been used by many therapists as a way of helping clients; for example, in the work
of the US psychologist, James Pennebaker.
In reflecting on your experience of writing about yourself, consider the following
questions:
G What impact has this experience had on you? Has it been helpful to write about
yourself, or unhelpful?
G What are the ways in which writing has been useful or otherwise for you?
G What have you learned about what is the best time and place for you, in terms of
productive personal writing?
G What have been the differences that you have noticed, between talking about an
issue or experience, and writing about it?
G In what circumstances might you use writing activities with clients? How might
you integrate writing tasks into your face-to-face conversations with clients?
In relation to the autobiographical dimension of these writing activities, it may be useful
to reflect on questions such as:
G What effects have you noticed, in terms of your feelings about your life and
your attitude towards yourself, that have arisen from your autobiographical
writing?
G Has your autobiographical writing helped you to identify episodes or events in
your life that were previously out of your awareness? How useful (or otherwise) has
it been for you to remember these instances?
G What are the distinctive personal strengths and accomplishments that you have
uncovered through exploration of your autobiography?
G How might a full and rich understanding of your own biography or life history help
you in your work with clients?
G To what extent, and in what ways, do you encourage your clients to articulate and
reflect on their life stories?
Building on life experience 49

Further reading
Bolton, G., Howlett, S., Lago, C. and Wright, J.K. (eds) (2004) Writing Cures: An Introductory
Handbook of Writing in Counselling and Psychotherapy. London: Brunner-Routledge.
McAdams, D.P. (1993) The Stories We Live By: Personal Myths and the Making of the Self.
New York: William Murrow.
Pennebaker, J. (1997) Opening Up: The Healing Power of Expressing Emotions. New York:
Guilford Press.
Pennebaker, J.W. (2004) Writing to Heal: A Guided Journal for Recovering from Trauma and
Emotional Upheaval. Oakland, CA: New Harbinger Press.
Being a member of
a learning group:
working together
to develop
self-awareness

Section contents
Introduction 53
Exploring your feelings, fantasies and expectations about the group 55
Using the group to experiment with new ways of relating to others 56
Making connections and being responsive to others 57
First impressions of group members 59
Talking about yourself in the group 61
Reflecting on significant events in the group 62
Endings: reflecting on the life of the group 64
A brief introduction to concepts of group dynamics 66

51
53

Introduction

There are several reasons why participating in a learning group can make an important
contribution to the personal and professional development of counsellors and psycho-
therapists in training:
G The way that a person responds to being in a group typically recapitulates earlier
experiences in family and friendship groups; the learning group provides a setting
for learning about these areas of personal development.
G The group is a setting for giving and receiving support and challenge.
G Responding to other members of the group provides ongoing practice in offering
the qualities of empathy, congruence and acceptance in relationships.
G Group members can give each other feedback on their reactions to what a person
has said or done in the group, thereby helping that person to become more aware
of how he or she is viewed by others.
G Group members can encourage each other to explore difficult topics in more
depth.
G Working in a group provides opportunities to learn how to engage constructively
with people who may be experienced as threatening, hard to understand or
different.
G Within a group, it is possible to become more aware of the universality of human
experience, and the interconnectedness of persons.
G Counsellors are sometimes called on to facilitate therapy groups the experience
of being a member of a learning group provides an appreciation of group dyna-
mics, and an introduction to what is involved in the role of group facilitator.
It is recommended that the learning tasks in this Workbook should be explored not
only individually; for example, through the medium of a personal learning journal, but
also collectively, in the context of a learning group. The group may be facilitated by a
tutor or external consultant, or may be a peer group comprising only course members
or co-learners. The group may be a formal element in a training course, or organized
by course members within their own time.
The learning tasks in this section are designed to enable users of the Workbook to
make the most out of the experience of taking part in a learning group. The first two
learning tasks outlined below should be completed in advance of the first meeting of
the group. It is useful to try the Making connections and being responsive to others
exercise near the beginning of the group it is intended to function as a model or
template for how the group might work together. Other exercises are intended to be
completed as soon as possible after each meeting of the group. There are also some
activities that can be used towards the end of the life of the group to enable members
of the group to reflect together on how the group has functioned, and what it has meant
to them.
54 The counsellors workbook

Appendix A (p. 209) provides a set of guidelines for tutors and trainers on how to
run a personal development group based on the activities in this Workbook using a
narrative approach. These guidelines can readily be adapted for groups of learners
who might wish to meet on a peer group basis in the absence of a designated leader
or facilitator.
55

Exploring your feelings,


fantasies and expectations
about the group
Before the first meeting of your learning group, take some time to write freely about
your feelings and fantasies about this group:
G What do you hope will happen in the group?
G What are your fears in terms of awful things that might happen in the group, or that
you might be called on to do?
G Where do these reactions come from in terms of your own life history?
Having explored your expectations for the group, what have you learned about how a
counselling client might feel in making a first appointment, and anticipating his or her
first meeting with a therapist?
What are the group norms or rules that are particularly important to you? In relation
to establishing ground rules for the group, take a few minutes to note what you want to
see happen, in relation to such factors as:
G starting and finishing on time;
G what happens if people do not turn up;
G talking outside the group about what has happened inside it;
G touching each other;
G what happens if someone walks out during a session;
G pressure to talk/freedom to remain silent;
G honesty;
G the role and responsibilities of the facilitator;
G the role and responsibilities of group members;
G how decisions are to be made, about how the group uses its time.
Having explored some of your ideas about desirable and undesirable group norms, take
some further time to reflect on the implications of what you have written for your role as
a counsellor, and your experience of being a client in therapy. To what extent, and in
what ways, have you participated in discussing norms or ground rules for counselling
and psychotherapy with your therapist or with your clients? How useful might it be to
do more of this?
Finally, reflect on your reading of therapy theory so far, particularly the theory or
theories of therapy around which your training course is built (or the theories that have
most personal meaning and utility for you). What do these theories have to say about
processes of therapeutic learning and change? What do you think should happen in the
group if it is to become an environment within which these processes will occur to
maximum effect? What does optimal (or non-optimal) group functioning look like from
the perspective of your preferred theories?
56

Using the group to


experiment with new ways
of relating to others
As we grow up, we tend to develop a specialized role in our family. For example, some
people find themselves playing the role of peacemaker, while others will consistently
be in the role of troublemaker, quiet one, joker, source of good ideas, dreamer,
and so on. Usually, people carry these roles into other groups in which they are
involved. For example, someone who was a troublemaker in their family might also
ask awkward questions in staff meetings at work, or always be trying to bend the rules.
The existence of these roles is inevitable, but also carries negative implications for the
practice of counselling. Our clients require us to be able to respond to them in a wide
range of ways, and not always to revert to our preferred role position. The learning
group provides an opportunity to experiment with your own role flexibility.

Instructions
G Identify the group role or roles that you have typically fulfilled in your family of
origin or other groups.
G Identify a new and different role that you have seldom or never played in a group,
and which represents an aspect of yourself that you would like to make more
available. For example, if you have tended to be the quiet one in groups, you
might choose to develop your capacity to be someone who is a constant source of
ideas.
G Plan and rehearse your strategies for acting this new role. For example, who are the
models (people you know or people you have observed in movies or on TV) that
you might base yourself on?
G Take every possible opportunity to play this new role in the group.
G Use your personal learning journal to reflect on the experience of this new role
what it felt like, how other people responded to you in a different way, what
happened to the role that you previously fulfilled.
This exercise can include (optionally) disclosing to other group members what your
experimental role will be, and inviting them to give you feedback when they notice
you performing both the new role and your older more familiar roles.
Towards the later stages of the life of the group, reflect on the personal and profes-
sional implications of what you have learned through this activity. What are the
implications for your own sense of self the way that you understand yourself and
describe yourself to others? What are the implications for your understanding of how
people change in therapy, through carrying out behaviour change experiments?
57

Making connections and


being responsive to others

The aim of this exercise is to explore the experience of being open to the experience
of another person, and letting that person know how their story has had meaning for
you. These are processes that are essential aspects of the learning group, and are
intrinsic to a narrative approach to working together in groups.
It is important to take responsibility for yourself what you share is under your
control. It is important to be respectful of others by being supportive and honest, and
holding confidentiality.
This learning task involves taking it in turns to carry out the activity described below.

1 Telling the story of a development in your life

Take a few moments to think about developments in your work or life that you are
pleased with. Choose one such development to describe to the group. Tell a bit of the
story of what happened. Say something about the beliefs, intentions and commitments
that this development contributes to in your life. Take time to get a rich description of
the meaning of this development for you.
Once you have described this pleasing development in your life, reflect on these
further questions:
G Who is someone in your life who would be least surprised to hear you talking
about these intentions or commitments someone you know or once knew who
would recognize and value the commitment you were talking about? It may be
someone you actually know or knew, or it could be a character in a book or story.
What is this persons name? What do they look like? When did you know them?
Are there any special things about them?
G What might this person have noticed you doing in the past that might have helped
them to notice the commitment that you spoke of just now? What might it have
meant to this person to have seen how this commitment was important to you, and
the actions that you have taken to fit with it? What contribution do you imagine
that this might have made to their life?
G If you were to see yourself now through that persons eyes, what would you most
appreciate about yourself?
G What difference would it make to you, in your work and life, if you were to hold
the presence of that person with you in what you do?
You will have about 10 minutes to tell this story in the group.

2 The responses of those who witnessed the story

The intention is not to praise/applaud or criticize the person who told the story, or to
interpret their story in theoretical terms, or to offer a therapeutic response. The aim,
58 The counsellors workbook

when making a response to a story you have heard, is to use the experience to thicken
your own story, and that of the teller, by making connections.
The following questions can be used to help you to shape your response:
G What caught your interest? What touched or moved you in what you heard? As you
listened, which expressions caught your attention or captured your imagination?
G What images of this persons life, their identity and the world more generally, did
these expressions evoke? What did these expressions suggest to you about the
persons purposes, hopes, beliefs, values, dreams and commitments?
G What did this have you thinking about in relation to your own work and life?
Which aspects of your own experiences of life resonated with the images and
expressions of the teller? What is it about your own life that meant you were
touched in this way?
G Where does hearing this take you? How will it contribute to possibilities in
your own life? Where have you moved to in your thinking or experience of life?
How is your life different for having moved to this new place?

3 The process of going round the group

Each member of the group, in turn, shares his or her response to the story of a develop-
ment . . . that they have heard until everyone has offered a response. Once this
round is complete, another member of the group tells his or her story of a pleasing
development, followed by a further set of responses.
Leave 10 minutes at the end, after everyone has told their story and been responded
to, to reflect together on the experience of doing the exercise. What did you learn about
yourself and your relationships with others?

Further reading
Morgan, A. (2000) What is Narrative Therapy? Adelaide: Dulwich Centre Publications (Chapter 14).
White, M. (1997) Narratives of Therapists Lives. Adelaide: Dulwich Centre Publications
(Chapter 10).
59

First impressions of
group members

The first meetings of a learning group represent a situation in which it is possible to


reflect on the significance of first impressions. The first encounter between people is
one in which a great deal of information is processed very quickly. The process that
takes place can be regarded as an example of intuition, where conclusions about a
person are reached without being able to explain any logical grounds for them. This
kind of intuitive competence is important for therapists, who need to be able to respond
to clients on the basis of a holistic, immediate, felt sense of what may be happening
in the therapeutic relationship. As a relationship develops, a person is able to engage
in impression management, to create a preferred image of who they are, in the minds
of those with whom they interact. Being sensitive to first impressions opens up the
possibility of being able to reflect on what it might mean that ones image of another
person changes over time: when I first met him/her, I thought that he/she was . . ., but as
I got to know them, I realised that they were. . . .
Make notes in relation to the following questions:
G What were your first impressions of other group members, and the group
facilitator?
G For each person, who did they remind you of?
G Describe the physical presence of each person.
G Describe the voice quality of each person.
G Who did you feel close to from the start?
G Who did you want to move away from?
G Think of each group member as an animal which animal would they be?
G What was it like for you the first time you directly engaged in conversation with
each member of the group?
Having recorded these first impressions, take some time to reflect on what they
might mean:
G How do you make sense of these first impressions in terms of the connections in
your own mind between this group and other groups to which you have belonged?
Are there the same set of characters in this group as in other groups in which you
have been a member? If so, what are the implications for your sense of the drama of
your own life?
G How do you make theoretical sense of these first impressions? For example, if the
members of your learning group trigger memories of people from your childhood,
would this would be a confirmation of the psychoanalytic theory of transference?
In what other ways could you explain these first impressions?
G What are the implications of first impressions for the establishment of a collaborative
relationship between a therapist and a client?
60 The counsellors workbook

Further reading
The topic of first impressions and intuitive decision-making is discussed in:
Gladwell, M. (2006) Blink: The Power of Thinking without Thinking. London: Penguin.
61

Talking about yourself in


the group

At some point near the start of the learning group, you will be expected to share aspects
of your life story with other members of the group. As the group moves on to other
topics, you may be called on to disclose early memories, your feelings about your
sexuality, and other sensitive and personal topics.
Use your personal learning journal to reflect on your experience of talking about
yourself:
G What was this like for you to talk about yourself?
G How did you feel when it was your turn? At what point did you volunteer early or
late?
G What did your way of dealing with disclosing sensitive personal stories tell you
about yourself?
G What information about yourself did you hold back? To what extent was this a
conscious choice, or did you just forget to talk about certain areas?
G What held you back from telling your story (e.g. lack of trust, a belief that other
people would not be interested in you, etc.)?
G What made it easier for you to talk about yourself?
G What did you observe in other people in terms of the ways in which they coped
with these tasks?
G What was it like to listen to other stories? Did these personal stories help you
feel closer to other group members, or otherwise? If it did help you to feel closer,
then how and why is it that personal storytelling can have this kind of effect?
What are the implications for your practice of therapy, of what you have learned
about the challenges involved in sharing personal stories, and the ways in which
self-disclosure can be inhibited or facilitated?
How do you make sense of your own, and other peoples performances, in terms
of theories of personality and psychopathology? For example, to what extent does
it make sense to interpret the ways in which people tell their stories in the group,
as examples of narcissism (listen to my story and you will realize how wonderful I
am), early attachment difficulties (my story isnt really very interesting I dont expect
anyone will want to hear it) or other patterns?

Further reading
Farber, B.A. (2006) Self Disclosure in Psychotherapy. New York: Guilford Press.
62

Reflecting on significant
events in the group

After each session, take a few minutes to write a description of the most significant event
that happened in the group that week. A significant event or moment can be anything
that happened that is memorable and meaningful for you. Your account of the event
should include:
G what led up to the event;
G what took place;
G what the consequences were (i.e. whether and how the climate of the group shifted
afterwards, and in what direction).
Describe your own involvement in the event (whether as an active participant, or
passive observer), including your thoughts, feelings and fantasies, and what you did
and said (or wanted to do and say).
Creating a series of event descriptions of this kind can be invaluable in tracing the
development of the group, and the changes taking place in your own role in the group.
Yalom (2005) suggests that there are different types of helpful factors in groups:
G group cohesiveness;
G instillation of hope;
G universality;
G catharsis;
G altruism;
G guidance;
G self-disclosure;
G feedback;
G self-understanding;
G identification;
G family re-enactment;
G existential awareness.
You can deepen your appreciation of group processes by looking at how the events you
have described can be understood in terms of these categories, and reading Yaloms
(2005) discussion of the broader significance of these types of process. It may also be of
interest to reflect on the difference between significant events in which you were
directly involved as a key actor, and those where you were an observer. Finally, it can be
illuminating to compare your ideas about significant events with the events identified
by other members of the same group, and try to make sense of any differences in
perception that emerge. Not everyone in the group will identify the same events as
being significant.
If you have collected significant event descriptions over the life of the group, look at
Being a member of a learning group 63

whether different types of event were observed in the later stages of the life of the group
compared to the early stages. If there are differences, what might this mean in terms of
an understanding of group processes?
Finally reflect on what you have learned from this exercise about the process of
individual counselling and psychotherapy. Do different types of change event occur in
individual therapy compared to group therapy? Or do the same kinds of thing happen,
but in a different form?

Further reading
Bloch, S., Crouch, E. and Reibstein, J. (1981) Therapeutic factors in group psychotherapy, Archives
of General Psychiatry, 38: 51926.
Yalom, I.D. (2005) Theory and Practice of Group Psychotherapy, 5th edn. New York: Basic Books.
64

Endings: reflecting on the


life of the group

In preparation for the ending of the learning group, it can be useful for group members
to reflect together on how they have worked together.

Exercise: being on a journey together


Take some time to draw a picture of the group, and all its members, as if it was a boat of
some kind on a journey. What kind of a boat is it? What kind of a journey is it on? What
roles have different members (and the facilitator) played captain, crew, passengers,
cargo, saboteurs, rescuers, and so on? What was the journey like what were the
most memorable episodes? Use your imagination, and imagery and colour, to create a
picture that represents your own personal experience of the group over the last few
months. Each person brings their picture into the group, shows it to your fellow group
members, and talks them through what it means. This exercise is intended to open
up the process of reflecting on the group experience. The group journey metaphor
allows members to sum up their feelings about the group as a whole.

Exercise: reflecting on key aspects of the group experience


There are many different processes that can take place in learning groups. In any par-
ticular group, some of these processes may be more salient than others. Read through
the list of questions below, and create a space to reflect and write on the ones that seem
to you to be most significant in relation to your own learning group experience. If you
have kept notes of what happened in the group, week by week, it will be easier to
explore these issues in depth.
1 The emotional climate of the group: what were the main feelings and emotions
that you experienced in the group? Did you have different feelings and emotions
at different times? How did you express or act on these emotions? How did you
observe other people acting on their emotions?
2 Leadership style: what was facilitative for you and other people in the group? What
kinds of process made learning and change possible? What has been the facilita-
tive style of the leader? What have been the advantages and disadvantages, or
consequences, of that style for the group as a whole and for you as an individual?
3 The development of group norms and culture: were there any phases or stages in
the life of the group? How would you describe the different characteristics and
feel of each of these stages? What word or image would you use to describe
each stage? Were there specific transition points or events that marked the shift
from one stage to the next? What were they? How would you describe your own
Being a member of a learning group 65

behaviour and activity at each stage or phase of the group? How did you behave
or feel differently at each stage? At which stage did you feel most comfortable or
at home?
4 Group roles: in what ways did you act consistently in the group; for example, by
saying the same kinds of thing in different sessions, or responding to particular
kinds of event in a certain manner? How would you describe your consistent way
of being in the group? Did you have a specific role within the group? Did this role
change over time? What roles did you observe other people playing? Did their
roles change over time?
5 Relationships between group members: how was the issue of intimacy handled
by the group? Getting close to others in a professional arena can be threatening
and confusing. How did you cope with this? What did you feel? What did you do?
Did you allow yourself to get close? When you observed intimacy between other
group members, how did you feel about this? What values, moral and ethical
issues does the level of intimacy in the group raise for you?
6 The group as an arena for family re-enactment: what has being a member of this
learning group evoked for you in terms of your experience of being a member of a
family? Did you enact roles and patterns of interaction that you learned in your
family of origin?
7 The group as a context for exhibiting therapist qualities and competences: having
spent all these hours in a learning group with a set of colleagues, who would you
go to (or recommend a friend or family member to consult) as a therapist? Have
you shared these views with colleagues in the group? Who do you intend to stay
in contact with after the ending of the group?
Use these questions to reflect on:
G what you have learned about yourself as a person: the self-discoveries and insights
that have been triggered by interacting with other members of the group on a
shared learning task;
G what you have learned about the process of counselling and psychotherapy:
what did you experience and observe in the group that can be useful for your work
as a therapist?
G what you have learned about how groups operate; for example, group norms,
stages in the life of a group, roles within groups, and so on.
66

A brief introduction to
concepts of group dynamics

When reflecting on the experience of being a member of a learning group, it can be


helpful to be able to make sense of these experiences in the context of an appreciation
of how groups operate, and the distinctive issues and learning opportunities that are
highlighted by the process of the group. The area of group dynamics has been a central
focus for social psychology and sociology for more than a century, and there exists a
wealth of theory and research on this topic. An introduction to some of the main
concepts that are used in theories of group dynamics is provided below.

The needs of individual members


In any group there is a task to be fulfilled. The nature of the task will be different for
different groups. For example, management groups must make decisions, ward-based
nursing teams must organize and deliver patient care, and learning groups must create
an environment for the acquisition of new skills and knowledge. But in all these
groups the achievement of the groups goals, the fulfilment of its primary task, will be
strongly influenced by the quality of the relationships that exist between group
members. This is because people are not robots or machines, but have needs that
they try to satisfy through contact with colleagues and clients. There appear to be
three broad areas of interpersonal needs that are relevant to the way that people act
in groups:
1 needs for inclusion/belonging/acceptance;
2 needs to feel in control of the situation, for power, influence, to experience a
sense of order;
3 needs for liking/affection/intimacy/expressing feelings.
Various theorists and researchers have observed that in many groups, the salience of
these needs changes over time. At the beginning of the life of a group, people are
particularly concerned about whether they will be included and accepted by others.
This phase may raise personal issues around the persons sense of belonging. The group
may then shift to a concern with the question of how it is going to get things done.
Needs for order and control, or individual freedom from external constraint, may come
to the fore. Also, this stage in the life of the group can raise issues around the perceived
need for a strong leader (dependency needs). Finally, the group may reach a stage
where there is the possibility for authentic connection and intimacy between group
members. At this point, some of the fears and inhibitions associated with interpersonal
closeness may be exhibited.
Being a member of a learning group 67

The group as a system


Any human group can be seen as a complex system of relationships, task and roles.
Often groups of people fail to work effectively together because there is something
wrong with the system, rather than because of any inadequacies of individual members
of the group. It is important to remember this fact, because it can be easy to attribute
blame to individuals when something goes wrong, rather than recognize that the
real problem is rooted in the way the group functions as a system. Three of the most
fundamental aspects of group systems are their norms, their composition and their
boundaries.
The norms of a group represent the shared (and usually unconscious or taken-for-
granted) assumptions that group members have about what is OK in the group and what
is not OK. Some of the questions that are useful to ask about the norms of a learning
group include:
G Is it alright to disagree?
G Is it alright to express feelings? Which feelings?
G Is there a norm for excellence/quality?
G Is it OK to help or support other group members?
The composition of a group can critically affect the way it functions. Some of the
important questions here include:
G Are there too many/too few members to permit efficient decision-making, com-
munication, and so on.
G Is there an appropriate mix of role specialists (e.g. individuals who are task-
oriented, supportive, creative, critical, humorous, and so on)?
The boundary of a group is like an invisible, but psychologically very real, barrier or
fence around a group. When you are in the group you know you have crossed that
boundary. It is very difficult for a group of people to see themselves as a unit, or a group,
in the absence of a secure boundary. Significant boundary questions include:
G How does someone cross the boundary to enter the group? What are the
membership rituals?
G Can new ideas or information appropriately cross the boundary?
G Is the boundary strong enough to withstand pressure from external sources?
G Are there any internal boundaries (e.g. sub-groups, cliques)?
G Who looks after the boundaries?

Group roles and leadership


Effective leadership is essential for any group to perform well. However, it is necessary
to recognize that the most effective leadership is not something that is only provided
by the one individual who is designated as the boss or the facilitator, but is a quality
of a group to which all its members contribute. For example, there cannot be a leader
with followers. Also, each person in a work group will have some ideas or qualities
68 The counsellors workbook

that they can offer there are a wide range of roles that need to be fulfilled in a
group, each of which makes its own unique contribution to a leadership or directional
function. Key questions about leadership in groups include:
G Who supplies the group with an overall sense of direction or vision? How is
this achieved?
G Who coaches group members who might not be doing well at their individual
tasks?
G How is good work recognized and rewarded?
G Who monitors the operation of the group and initiates action to change things
that are not going well?
G Who makes sure that adequate resources are made available so that each member
of the group or team can do their job properly?

Change
One of the most fundamental aspects of any social group is that it changes over
time. Personnel, priorities, norms, tasks and level of effectiveness all change over the
lifetime of a group for a multitude of reasons. This is why many writers about small
groups talk in terms of group dynamics or group processes. It is important to be aware of
change processes in order to be able to understand and cope with situations where the
group is either stuck or seemingly engaged in a process of chaotic, rapid change. Some
useful questions to consider here are:
G How does the group deal with the arrival or departure of members?
G How is time structured? For example, when an important decision is to be made,
does the group decide to go through phases of information-gathering, evaluation
and action, or when there is a meeting, is there an agenda?
G How does the group take care of endings? Is unfinished business always dealt
with? Does the group celebrate its successes?
G Is the group capable of adapting to changed circumstances?
In some ways, these changes can be seen to unfold as discrete stages or phases in the
life of a group. In other ways, however, change in a group can occur over short periods
of time, and may take on a cyclical quality, with the group passing fairly rapidly through
a sequence of distinct states of functioning.
These themes personal needs in relation to others, responding to change, adapting
to the social norms are central to the experience of being a person. As a result, being a
member of an intensive small group can represent a situation in which a person can
learn a great deal about how they are, and how they relate to others. A small learning
group can be viewed as a microcosm of other social groups that a person has experienced
during their life. In such a group, people reproduce patterns of being-in-relationship
that reflect the ways that they felt and acted in earlier groups in their life, such as their
family of origin, or friendship groups at school.
Being a member of a learning group 69

Further reading
A useful overview of theory and research on group dynamics can be found in:
Forsyth, D.R. (1990) Group Dynamics, 2nd edn. Pacific Grove, CA: Brooks/Cole.
Some of the most interesting perspectives on group dynamics are derived from psychoanalytic
theory, particularly the ideas of the British psychoanalyst, Wilfred Bion:
Bion, W. (1961) Experiences in Groups. London: Tavistock.
Rioch, M. (1970) The work of Wilfred Bion on groups, Psychiatry, 33: 5666.
Whitman, R. and Stock, D. (1958) The group focal conflict, Psychiatry, 21: 26976.
A classic paper, which presents a model of the interconnectedness of group, roles and group
stages, is:
Bennis, W. and Shepard, H. (1956) A theory of group development, Human Relations, 9: 41557.
Issues associated with the use of small groups to facilitate individual learning and self-awareness
are discussed in:
Benson, J. (2000) Working More Creatively with Groups, 2nd edn. London: Routledge.
Blumberg, A. and Golombiewski, R. (1976) Learning and Change in Groups. London: Penguin.
Lago, C. and Macmillan, M. (eds) (2000) Experiences in Relatedness: Groupwork and the
Person-centred Approach. Hay-on-Wye: PCCS Books.
Whitaker, D. (1985) Using Groups to Help People. London: Tavistock.
Yalom, I. (2005) Theory and Practice of Group Psychotherapy, 5th edn. New York: Basic Books.
Making sense:
constructing a
framework for
understanding

Section contents
Introduction 73
What are the key theoretical ideas that you use? 75
What is your relationship with theory? 76
Identifying different levels of theorizing 77
Meta-theories: how do they shape the way you think about counselling? 79
Applying theory: making sense of personal experience 81
Empathy: a key concept in counselling 83
Making sense of self 85
How theory is applied in practice: key cases 87
Applying cognitivebehavioural concepts 88
Irrational beliefs and dysfunctional self-talk 90
Developing a cognitivebehavioural case formulation 91
Congruence: the use of self in counselling 92
Experiencing authenticity 94
The balance between problems and solutions 96
Specific techniques or common factors 98
Positioning your practice in relation to social and political factors 100
The idea of the unconscious 101
What brings about change? The relative importance of cognition and emotion 103
Behind the theory: the life of the theorist 105
The cultural context of understanding 107
What kind of therapeutic relationship? 108
Dialogue between theorists 110
Are you postmodern? 112
Letter to a theorist 114
The concept of transference 115

71
73

Introduction

The work of a counsellor or psychotherapist inevitably involves listening to people talk


in detail about complex situations in their lives. Often, the persons way of telling his or
her life story may be halting, incoherent, or punctuated by strong emotion. Almost
always, there will be gaps in the story things not said, things that may be too embar-
rassing or shameful to share with another person. Listening to such stories, in a context
in which you are expected to do something to help, can be a confusing and overwhelm-
ing experience. Where to start? What does all this information mean? What can I say or
do to make things better?
Theory provides a framework for understanding, a preliminary map of the territory
that might be explored, and a set of suggestions for possible directions of travel. It is one
of the core functions of training to enable the trainee to find a theoretical home. Some
therapists prefer to develop membership of a coherent theoretical community, centred
around one of the main approaches to therapy, such as psychodynamic, person-centred
cognitivebehavioural therapy. Other practitioners choose to follow a more integrative
or eclectic path. In either case, it is essential to become thoroughly familiar with the
theoretical constructs and language that one decides to use. All the big, important
concepts within therapy theory the unconscious, the self, cognitive schema can be
understood or interpreted in different ways, and have multiple meanings and implica-
tions according to the circumstances in which they are used. Possessing a superficial
understanding of such ideas can lead a counsellor into difficulties; for example, if a
client realizes that their therapist is only pretending to understand, is hiding behind
technical jargon, or is contradicting him or herself.
The activities in this section of the Workbook are designed to approach the goal of
making sense and constructing a framework for understanding in a variety of ways.
These activities invite you to:
G reflect on the role of theory in counselling practice;
G explore your own personal theories and how these fit with the counselling
models you have encountered;
G look back at the implicit theoretical assumptions expressed in the writing you did
in Section 1 of the Workbook;
G examine key concepts in depth.
Throughout these learning activities, you are encouraged to build up a sense of your
own personal framework for understanding. Many of the tasks ask you to identify your
own position in relation to the theoretical ideas that you are exploring. The rationale for
this is that your own personal framework for understanding is always more than any
single theory of therapy can provide. Responding to people in crisis always involves
drawing on your life experience and common sense, as well as your knowledge of
74 The counsellors workbook

therapy models. It is important, therefore, to know where you stand in relation to the
theoretical traditions that inform your work.
Later sections in the Workbook build on your exploration of theory; for example, in
applying theory in understanding individual cases, or in resolving practice issues. The
exercises in Section 6, Developing a professional identity: putting it all together, give
you opportunities to integrate or sum up your theoretical position.

Further reading
The role of theory in counselling and psychotherapy practice is discussed in:
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(Chapter 3).
75

What are the key


theoretical ideas that you use?

If you read between the lines of most counselling, psychotherapy and personality text-
books, you will find that there is a set of core questions, related to the basic processes of
counselling, which any theoretical model needs to be able to answer. These questions
include:
G What are the causes of peoples problems?
G What are the main mechanisms and processes of change? What changes? How?
G What is the role of the therapist? What is the optimal type of counsellorclient
relationship? Why is the relationship important? Why is it necessary to have a
strong therapeutic alliance?
G What are the criteria for success and failure in counselling or psychotherapy? What
are the goals of therapy?
G What is the relative importance, in terms of making sense of clients problems and
the process of therapy, of:
cultural factors (including social class, ethnicity and gender);
cognitive factors (the way the person thinks about things; the persons beliefs);
emotion (how the person feels about things);
biological/genetic factors?
Make brief notes in response to all these questions. Just write down whatever answers
come into your mind.
Which theoretical ideas and concepts appear in your answers to these questions?
Do these concepts all derive from a single theoretical model, or do your answers
contain a mix of ideas?
You may find it helpful to use a large sheet or roll of paper to map out your thinking
in relation to these key theoretical questions. What you produce will almost inevitably
be complex and incomplete, and indicate potential areas for further reading and study.
76

What is your relationship


with theory?

The social psychologist, Kurt Lewin, once said, There is nothing as practical as a good
theory. Do you agree? How important is theory for you?
As fully as possible, explore your responses to these questions:
G What are the theoretical ideas or concepts that you refer to most often, in terms of
your own personal thinking about counselling issues, and your discussions with
other people around these matters? How deeply have you studied these concepts?
Have you mainly learned about these ideas or concepts from general reading, or
listening to other people, or is your knowledge based on extensive reading?
G What are the theoretical tensions or dilemmas that you are aware of in your work
as a counsellor (or in your reading as a trainee/student)? Are there times when you
are caught between different ways of making sense of a client (or any person you
are helping), or of your role in relation to a client? What do you do when you have
this kind of experience?
G What is the direction of your theoretical development? Are there earlier theoretical
ideas that you have grown out of? Where do you feel that your theoretical inter-
ests are heading? What do you feel you want to (or need to) read next?
G For you, what is the ideal balance between making sense of the process of counsel-
ling in terms of an explicit theoretical formulation, and arriving at an intuitive, gut
response to what is happening?
G On the whole, how satisfied are you with your current relationship with counsel-
ling/psychotherapy theory? Do you feel that you may sometimes over-theorize,
and thus perhaps lose touch with what is taking place in the moment? Or do you
struggle to detach yourself from the moment-by-moment complexity of counsel-
ling and perhaps lack an ability to develop a conceptual overview?
What are the implications of your responses to these questions for:
1 your practice as a counsellor or psychotherapist?
2 your ongoing professional development, for example, in respect of further read-
ing and study?
77

Identifying different levels


of theorizing

The previous exercises in this section invited you to explore and write down the
different theoretical ideas that you use in thinking about therapy. In trying to make
sense of how these concepts fit together, and how they might influence your work
with clients, it can be helpful to consider them in terms of different levels of
abstraction.
There are three levels of abstraction within any theoretical model used in counsel-
ling and therapy:
1 statements about observational data;
2 theoretical propositions, which make connections between different observations;
3 underlying philosophical assumptions.
For example, within psychoanalysis, statements about, for example, defence mechan-
isms such as projection or denial are fundamentally simple observations of behavioural
events. However, psychoanalytic concepts such as anal personality go beyond mere
observation, and made inferences about the connectedness of events separated by time
and space. For example, the idea of anal personality implies a link between childhood
events (potty training) and adult behaviour (obsessionality), and this association is
inferred rather than directly observed. Finally, concepts such as the unconscious and
libido refer to philosophical abstractions that cannot be directly observed but are used
as general explanatory ideas.
The use of lower-level, observational constructs can be seen to carry relatively little
in the way of theoretical baggage. For example, describing a client as using the
defence mechanism of projection might be an effective shorthand means of giving
information to a supervisor or colleagues in a case conference.
Higher-level philosophical constructs and concepts, by contrast, cannot be as easily
taken out of the context of the theoretical model within which they fit. A term such as
libido (Freudian theory) or self-actualization (Rogerian/person-centred theory) can-
not be used without making a substantial number of philosophical assumptions about
what it means to be a person. As a result, any attempt to combine libido and self-
actualization in the same conversation, case study or research project is likely to lead
to confusion. Thinking about people as basically driven by libidinous desires (Freud) or
as basically driven by a drive to wholeness and fulfilment (Rogers) are very different
philosophical positions.
The middle level of theory, which involves theoretical propositions such as Freuds
explanation of the anal personality, or Rogers model of the core conditions for
therapeutic change, is potentially the most useful level of theory for practitioners,
because it deals in supposedly tangible cause-and-effect sequences that give the coun-
sellor a handle on how to facilitate change. The difficulty here is whether the particular
explanation offered by a theoretical model can be believed to be true, or be viewed as
just one among many competing interpretations.
78 The counsellors workbook

Exercise
Examine the list of theoretical ideas that you use in your practice, and label
them as observational concepts, theoretical propositions or underlying philosophical
assumptions.
In what ways does this exercise allow you to discern the coherence within your
theoretical thinking, and also to identify areas of possible contradiction?

Further reading
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(Chapter 3).
79

Meta-theories: how do they


shape the way you think about
counselling?
Mainstream approaches to counselling and psychotherapy psychodynamic, person-
centred and cognitivebehavioural are based in competing psychological theories of
personality. Making a choice between these alternative psychological models is no easy
task. For the most part, the evidence from research does not make it possible to state
with any confidence that one psychological model is correct or valid, and that another
one is wrong. In practice, espousing a theoretical approach, or combination of
approaches, tends to be influenced by other broader sets of beliefs, values and ideas
with which the counsellor identifies him or herself. These ideas and beliefs can be
described as meta-theories, because they can be viewed as overarching systems of
thought within which psychological theories are embedded. The aim of this exercise is
to identify the meta-theories that are significant for you, and to explore the ways in
which these ideas shape your approach to counselling.

Instructions
On a piece of paper, create a display of the ideas or systems of thought that are most
significant in your life. Place the ideas that are most central for you in the middle of the
page, and the ones that are less important nearer to the edge.
These ideas can be drawn from a variety of domains:
1 Religious and spiritual beliefs that are important for you: for example, Christian-
ity, Buddhism, Islam, atheism.
2 Philosophical ideas that are meaningful for you: for example, existentialism,
phenomenology, empiricism, rationalism, postmodernism, constructivism.
3 Political ideologies that you support or oppose: for example, socialism, capital-
ism, individualism, feminism, environmentalism, consumerism, trade unionism,
gay rights.
4 Academic or scientific disciplines that have had a formative impact on the way
you view the world: for example, mathematics, sociology, anthropology, eco-
nomics, history.
5 Forms of artistic expression and creativity through which you find meaning: for
example, poetry, drama, cinema, music.
Once you have drawn your personal meta-theory map, take some time to reflect on
the implications of these ideas, beliefs and practices for your personal approach as a
counsellor:
G Which sets of ideas are most relevant to your counselling/psychothyerapy theory
and practice? Which ones are less relevant, or not at all relevant?
80 The counsellors workbook

G In what ways might these ideas shape the way you are, and the choices you make,
as a therapist?
G Which therapy theories and concepts are most (and least) compatible with your
meta-theories?

Further reading
Howard, A. (2000) Philosophy for Counselling and Psychotherapy: Pythagoras to Postmodernism.
London: Macmillan.
81

Applying theory: making


sense of personal experience

Earlier in the Workbook, in Section 1, Building on life experience: the foundations of a


personal approach, you were invited to write about a number of aspects of your own
life that represented everyday therapeutic processes that you may have encountered
either in the role of helper, or as someone seeking help from another person. A valuable
means of developing an awareness of your preferred position in relation to theories of
counselling and psychotherapy is to reflect on what you have written about yourself in
theoretical terms.
1 Read through some of the autobiographical pieces that you have written; for
example, your The story of a helping relationship, Thickening your auto-
biography: early memories or The experience of changing your own behaviour.
Identify any theoretical concepts that are implicit in what you have written. For
example, you may have described your experience in terms of being reinforced
by certain outcomes (a behavioural concept), or as involving the achievement of
insight (a psychodynamic concept). Is there consistency in the constructs and
terminology that you have used? If there is, what does this suggest to you about
your preferred theoretical position?
2 Choose one specific theoretical orientation (e.g. psychodynamic or person-
centred). From this perspective, read and interpret a sample of the stories that
you wrote in Section 1, Building on life experience: the foundations of a personal
approach. Be rigorous in only applying ideas from that specific approach, and do
your best to make use of a full range of concepts from the approach you have
selected. Once you have done this, consider the following questions:
G How satisfactory has this theoretical perspective been in accounting for all
aspects of your experience? In what ways did using this perspective lead you to
focus on some areas of experience at the expense of others?
G In what ways, and to what extent, did the use of a specific framework enable
you to develop a new or fresh understanding of the events and experiences you
had written about?
G What were the practical implications that were generated by the theoretical
framework you applied? Did the theory you were applying stimulate further
thinking and planning about how you might address issues in your life that
were problematic to you?
G Reflecting on the experiment of imaging yourself into a theoretical stance in
general terms, how credible and convincing for you was the theoretical inter-
pretation that you developed?
3 Apply different, alternative theoretical perspectives to your autobiographical
writings, following the guidelines in the previous paragraph. Which of the
perspectives seemed most useful to you? In what ways? Are there aspects of
82 The counsellors workbook

different theoretical models that you might wish to combine, to arrive at an ideal
overall framework for understanding? If so, what are the principles or values that
inform your choice?
83

Empathy: a key concept


in counselling

Carl Rogers suggested that when the counsellor/helper is able to understand the client,
and accurately convey that understanding, the person will become more able to accept
previously denied or warded off aspects of their own experience.
In person-centred counselling, it is important to stay within the frame of reference
of the client, to walk in their shoes, to see the world the way they see it, and not to
respond on the basis of your own projections, experiences or to offer advice.
Read what Rogers said about empathy:
The state of empathy, or being empathic, is to perceive the internal frame
of reference of another with accuracy and with the emotional components
and meanings which pertain thereto as if one were the person, but with-
out ever losing the as if condition. Thus it means to sense the hurt or the
pleasure of another as he senses it and to perceive the causes thereof as
he perceives them, but without ever losing the recognition that it is as if I
were hurt or pleased and so forth. If this as if quality is lost, then the state
is one of identification.
Rogers (1959: 325)
The way of being with another person, which is termed empathic, has several facets. It
means entering the private perceptual world of the other and becoming thoroughly at
home in it. It involves being sensitive, moment to moment, to the changing felt mean-
ings that flow in this other person, to the fear or rage or tenderness or confusion or
whatever that he or she is experiencing. It means temporarily living in his or her life,
moving about in it delicately without making judgements, sensing meanings of which
he or she is scarcely aware, but not trying to uncover feelings of which the person is
totally unaware, since this would be too threatening. It includes communicating your
sensings of his or her world as you look with fresh and unfrightened eyes at elements of
which the individual is fearful. It means frequently checking with him or her as to the
accuracy of your sensings, and being guided by the responses you receive. You are a
confident companion to the person in his or her inner world. By pointing to the possible
meanings in the flow of his or her experiencing, you help the person to focus on this
useful type of referent, to experience the feelings more fully, and to move forward in the
experiencing.
To be with another person in this way means that for the time being you
lay aside the views and values you hold for yourself in order to enter
anothers world without prejudice. In some sense it means that you lay
aside your own self and this can only be done by a person who is secure
enough in himself that he knows he will not get lost in what may turn out
to be the strange or bizarre world of the other, and can comfortably return
to his own world when he wishes.
Rogers (1975: 7)
84 The counsellors workbook

Consider the following questions:


G What are the key ideas in these statements? What are the changes in emphasis
between the two?
G To what extent do Rogers words capture what empathy means to you? You may
find it helpful to refer back to what you wrote in response to Feeling really
understood in Section 1 (p. 31), and reflect on whether the description given by
Rogers matches your own experience.
G What would you wish to add to Rogers ideas in order to arrive at an account of the
process of empathy that fully captured your own sense of this phenomenon?
G What are the personal challenges raised for you by these descriptions of empathy?
How readily can you sense the hurt or the pleasure of another or lay aside the
views and values you hold for yourself in order to enter anothers world. What
helps or hinders you in achieving this kind of contact with others.
G How important is the concept of empathy for you in terms of your own personal
thinking about counselling? Is it an essential force for therapeutic change? Or is it
merely one element of relationship building?
G In what ways do ideas and assumptions from other theoretical perspectives (e.g.
narrative, feminist, psychodynamic, cognitivebehavioural therapy) challenge or
extend a person-centred understanding of empathy?
85

Making sense of self

Self is a concept that occurs in most theories of therapy, for example, self-concept
(person-centred), self-object (object relations) and self-efficacy (cognitivebehavioural
therapy). The aim of this learning task is to help you to be clear about your own personal
understanding of the idea of self.
1 Reflect on the words you use when talking about counselling or psychotherapy.
How often do you use the term self? How often do you use other terms that are
broadly equivalent, such as ego, identity or personality? Which of these terms
sits most comfortably with your way of seeing relationships?
2 How important for you is the idea of self? Some philosophical approaches, such
as Buddhism and postmodernism, take the view that self is an illusion. Some
cultures make little use of the idea of an individual self, preferring to talk in terms
of we.
3 How do you define self? In Section 1 of the Workbook, you may have completed
an exercise titled The self puzzle in which you drew a picture of your self,
with each of the parts of the self labelled. Look again at that picture, and con-
sider which of the following elements of different self theories are expressed
within it:
G Core and peripheral self: is there a central section of your puzzle or map that
contains qualities or values that are, in some way, essential to your sense of
who you are? Are there sections towards the edge of your page that describe
values and qualities that are somehow less essential?
G Internalized self objects: object relations theory suggests that we include,
within the self, images of significant others, or parts of these others (such as
their words or voice) that are important to our emotional functioning. Are there
any such figures in your puzzle?
G Relational self: have you portrayed a relational self (lots of links to other people)
or a boundaried, autonomous self?
G Multiplicity or unity: does your picture convey a sense of a single entity, or are
there separate parts (sub-selves) that are separated from each other?
G Self-esteem and self-acceptance: person-centred theory assumes that the
extent to which a person accepts or values all aspects of self is an indicator of
well-being. To what extent is acceptance a theme in your picture?
G Self-efficacy: cognitivebehavioural theorists argue that the extent to which a
person views him or herself as being in control, and able to bring about
change, is a key dimension of self. Does efficacy, or agency, appear as a theme
in your drawing?
G Other dimensions of self: there are other dimensions of self that may be rele-
vant to you: consciousunconscious, actualization and fulfilment, spirituality.
86 The counsellors workbook

Once you have explored your self puzzle in the light of these ideas, it may be useful
to reflect on the degree to which your own personal theory of self is consistent
with the concept of self as articulated in the theoretical model(s) that inform your
practice.
87

How theory is applied in


practice: key cases

Over the years a number of counsellors and psychotherapists (and some clients) have
written case studies that express the complexity of their experiences of counselling.
Some of these case histories have become highly influential within the field, because
they have been regarded as defining how master therapists carry out therapy.
It is very useful to read case studies, because they provide a unique insight into
the ways that therapists think about their work. A case study also allows the reader
to arrive at their own sense of whether the approach to thinking about and work-
ing with clients that is being described actually fits with their own personal way of
being.
When you are reading or viewing a case study, keep in mind that it is a representa-
tion of therapy, which highlights some aspects of what is happening and glosses over
other elements. You may find the following questions helpful in reflecting on a case:
G How did you feel about the therapist? Would you have liked him or her to be your
therapist? Why, or why not?
G How did you feel about the client? If you had been the counsellor, how might you
have tried to work with him or her?
G What is helpful and/or unhelpful in what the therapist did?
G To what extent does the effectiveness of the therapy rely on the application of
specific techniques, as opposed to the creation of a strong relationship? What is the
balance between specific and non-specific elements?
G How strictly did the therapist keep to his or her espoused theoretical model? If and
when he or she diverged from the model, was this useful or did it seem to be a
mistake?

Further reading
Axline, V. (1990) Dibs: In Search of Self. London: Penguin
An account of the use of a client-centred or person-centred approach in therapy with a disturbed
young boy.
Dryden, W. (ed.) (1986) Key Cases in Psychotherapy. London: Croom Helm.
Gay, P. (ed.) (1995) The Freud Reader. New York: W.W. Norton. Includes several classic cases,
along with other important papers by Freud.
Wedding, D. and Corsini, R.J. (eds) (2000) Case Studies in Psychotherapy. Itasca, IL: F.E. Peacock
Publishers.
Yalom, I. (1989) Loves Executioner and Other Tales of Psychotherapy. London: Piatkus. A series of
fictionalized case studies by Irving Yalom, one of the leading figures in existential therapy and
a highly influential contemporary writer on therapy.
Pragmatic Case Studies in Psychotherapy (online journal).
88

Applying cognitive
behavioural concepts

Cognitivebehavioural therapy (CBT) is one of the most widely used forms of psycho-
logical therapy. Even if you are not a CBT therapist, it is important to be able to develop
an appreciation of the ways in which problems can be conceptualized and worked with
from this perspective. The intellectual origins of CBT are in behavioural psychology. The
reflective activities described below illustrate how two of the basic principles of
behavioural psychology operant and classical conditioning can be applied in the
analysis of everyday problems.

Operant or instrumental conditioning (functional analysis)


Choose an ordinary behaviour that you engage in every day. Examples might be: drink-
ing tea, drinking coffee, drinking beer or wine, listening to the radio, dancing, reading
the newspaper. . . .
Analyse this behaviour in behavioural terms:
1 What are the stimuli, situations or antecedents that elicit this behaviour?
2 What is the actual behaviour? Describe it in as much concrete detail as possible.
Try to describe it in terms of a sequence of behaviours.
3 What are the consequences of the behaviour? What follows it? How is the
behaviour reinforced or rewarded? Are there contingencies of reinforcement that
cause the behaviour to occur more frequently, or less frequently?
It can be instructive to try this analysis out on a range of different behaviours, including
habits that you might consider to be problematic in your life, such as smoking, eating
chocolate, nail-biting, procrastinating, and so on.

Classical conditioning
Choose one situation in which you feel moderately afraid, but which you feel OK about
exploring in a brief exercise. Examples could include: speaking in a seminar group,
meeting new people, being in an exam, being in a lift, looking out of a high window.
The following prompts take you through an analysis of your behaviour in terms of
the application of a classical conditioning model to the acquisition of a conditioned
emotional response.
G When was the first time you remember feeling like this? What were the original
unconditioned stimuli and responses (reflex responses) from which this fear pattern
originated? It may be hard to recall such an incident if you have had this fear for
some time. You may need to imagine a hypothetical situation in which you first
experienced this fear.
Making sense: constructing a framework for understanding 89

G What was the process of generalization that resulted in the present pattern of
fearfulness?
G In what ways has this fear led to an avoidance of certain situations or stimuli?
G To what extent has this avoidance resulted in the perpetuation or maintenance of
the fear pattern?
G Applying a behavioural approach, what could you do to extinguish the connection
between certain situations, and a fear response that you have identified in this
analysis.
Again, it can be interesting to try this analysis out on different behaviours.
Reflect on what you have learned from engaging with these exercises in terms of
your relationship with CBT as a way of making sense of personal problems:
G How useful did you find the application of these basic CBT concepts?
G Can these ways of thinking about problems be integrated or reconciled with other
theoretical frameworks you espouse (e.g. psychodynamic, person-centred) or do
they imply a completely different understanding of persons and lives?

Further reading
Westbrook, D., Kennerley, H. and Kirk, J. (2007) An Introduction to Cognitive Behaviour Therapy:
Skills and Applications. London: Sage.
90

Irrational beliefs and


dysfunctional self-talk

The emphasis in CBT is on analysing and changing cognitive processes and content
the way that a person thinks about his or her problems. This learning activity invites
you to explore some of the ways in which your own behaviour is influenced by such
cognitive processes.
Identify one situation or recurring scenario that you find difficult to cope with, such
as: saying no to a request that someone has made of you, lacking confidence when
working on a task, or feeling anxious, tense and afraid. Your task is to consider how you
might apply the ideas of Ellis regarding irrational beliefs, and Meichenbaum concerning
dysfunctional thinking/self-talk, to develop a better understanding of this problem.
Follow these steps:
1 Describe the situation or scenario in as much detail as possible. What triggers the
event? What do you do in terms of specific actions and behaviours? Most import-
ant, what goes through your head at these moments what are you thinking?
What do you pay attention to?
2 Can you identify irrational beliefs that may be triggered by the situation? Irrational
beliefs are exaggerated ways of thinking about yourself. An example might be
I must be perfect and do everything faultlessly . . . otherwise I am a completely
useless person.
3 Can you identify any sequences of self-talk that accompany your behaviour?
What is your stream of consciousness? Is there some kind of voice in your head
that could be making statements such as youll never get this right or no-one
will believe you could have the right answer.
4 To what extent, and in what ways, do these irrational or self-defeating beliefs and
cognitions undermine your ability to cope more positively with the situation you
are exploring?
(Note: it can be hard to recall dysfunctional cognitive processes after the event. You may
find it useful to carry around a notebook for a few days, and write down irrational
beliefs and critical self-talk at the time they occur.)
Reflect on what you have learned from this activity in relation to your theoretical
approach to counselling:
G How useful did you find the application of these CBT concepts?
G Can these ways of analysing a problem be integrated or reconciled with other
theoretical frameworks you espouse (e.g. psychodynamic, person-centred) or do
they imply a completely different understanding of what is involved in effective
therapy?
G What difference would it make to apply this kind of analysis with the help of
another person? What impact might the quality of the therapeutic relationship
have on the benefit you might gain from using this technique?
91

Developing a cognitive
behavioural case formulation

The aim of this learning task is to give you some experience of what it is like to apply
cognitivebehavioural methods in practice.
First, you need to identify a problem in your own life that is real but limited (i.e. not
too upsetting to look at). This could be something like smoking, eating too much choc-
olate, nail-biting, feeling anxious making a presentation to a group, avoiding complet-
ing a piece of work, and so on. Do not choose an issue that is too personal, difficult,
upsetting or traumatic. Choose a problem that is meaningful, yet manageable in the
context of a learning exercise: it is not helpful to open up difficulties or feelings that may
spill over from the exercise, and be disruptive to your life.
Your task is to formulate a cognitivebehavioural programme to deal with this
problem.
Follow these steps:
1 Build up a full description of the thoughts and actions/behaviours that make up
the problem. Describe in detail the sequence of stimuli, responses and reinforcers
that maintain the problem in place. You may find it helpful to map your analy-
sis of the problem behaviour on a large sheet of paper.
2 Identify your optimal scenario or goal what is your target for change? How
would you, ideally, like to behave in relation to this area of your life?
3 Develop a list of possible CBT techniques or interventions that might be
employed to help you to move towards your goal. Work out which order you
might try these interventions where would you start?
4 Make a list of your strengths and resources that would assist you in achieving a
change in relation to this problem, and also a list of factors that could undermine
your attempts to change.
Once you have completed your case formulation along the lines described above,
consider the following questions:
G How helpful do you think this approach would be in helping you to overcome
the problem? What other approach to counselling might help you better? Why?
G Have you tried any of these strategies before? Did they help? If not, then why didnt
they help?

Further reading
Bruch, M. and Bond, F.W. (1998) Beyond Diagnosis: Case Formulation Approach in CBT.
Chichester: Wiley.
Eells, T.D. (ed.) (1997) Handbook of Psychotherapy Case Formulation. New York: Guilford Press.
92

Congruence: the use of self


in counselling

Within the person-centred approach, the capacity of the counsellor to make construct-
ive use of their own feelings, reactions and imaginings in relation to the client is
considered as one of the key aspects of effective therapy. This way of understanding the
counsellors use of self is generally referred to within the person-centred approach as
congruence. Many other concepts have been employed to describe this phenomenon:
counter-transference, authenticity, transparency, genuineness, openness, presence,
honesty, resonance and immediacy.
Different facets of the person-centred idea of congruence are expressed in the
following definitions:
Congruence is the state of being of the counsellor when her outward
responses to the client consistently match her inner feelings and sensa-
tions she has in relation to the client.
(Mearns and Thorne, 1998: 75)
. . . the feelings the therapist is experiencing are available to him, and to
his awareness, and he is able to live these feelings, be them, and to
communicate them if appropriate. No one fully achieves this condition,
yet the more the therapist is able to listen acceptantly to what is going on
within himself, and the more he is able to be the complexity of his feel-
ings, without fear, the higher the degree of his congruence.
(Rogers, 1961: 61)
At every moment there occur a great many feelings and events in the
therapist. Most of these concern the client and the present moment. The
therapist need not wait passively till the client expresses something
intimate or therapeutically relevant. Instead, he can draw upon his own
momentary experiencing and find there an ever present reservoir from
which he can draw, and with which he can initiate, deepen and carry
on therapeutic interaction even with an unmotivated, silent or external-
ised person. . . . To respond truly from within me I must, of course, pay
some attention to what is going on within me. . . . I require a few steps of
self-attention, a few moments in which I attend to what I feel.
(Gendlin, 1967: 1201)
Reflect on these definitions and consider the implications they might hold for you in
relation to your work with clients.
Making sense: constructing a framework for understanding 93

Further reading
Mearns, D. and Cooper, M. (2005) Working at Relational Depth in Counselling and Psycho-
therapy. London: Sage.
Wosket, V. (1999) The Therapeutic Use of Self: Counselling Practice, Research and Supervision.
London: Routledge.
94

Experiencing authenticity

For person-centred and humanistic counsellors, authenticity is central to practice.


These learning tasks offer opportunities to reflect on your personal experience of offer-
ing, and receiving, authentic contact.

Mearns and Thorne (1988: 75) provide a list of concrete ways in which a personal
response to a client may be expressed. They formulate these ways as a set of questions
that a therapist might ask about his or her willingness to be involved in the relationship
with a client:

Can I dare to:


Feel the feelings that are within me?
Hold my client when I feel he needs to be held?
Show my anger when that is strongly felt?
Admit my distraction when challenged about it?
Voice my irritation when that grows?
Put words to my affection when that is there?
Shout when something is seething inside me?
Be spontaneous even when I dont know where that will lead?
Be forceful as well as gentle?
Be gentle as well as forceful?
Use my sensuous self in relation to my client?
Step out from behind my professional faade?
Can I dare to be me in response to my client?
How do you respond to these questions in terms of your own experience as a counsellor
or psychotherapist?

In your own personal experience (either in therapy or elsewhere) how often have you
felt that another person has been really congruent or genuine with you? Think of times
when this has happened. Take a specific instance what impact did the experience
have on you? How did it effect your relationship with that person?

When are you open to your self? What are the circumstances under which you make
discoveries about yourself, or deepen your story of who you are?

Reflecting on these tasks


What have you learned about yourself, and your approach to counselling, from
engaging with these tasks? How do you understand the impact of authentic contact on
the client, and on the therapeutic process?
Making sense: constructing a framework for understanding 95

Further reading
Mearns, D. and Cooper, M. (2005) Working at Relational Depth in Counselling and Psycho-
therapy. London: Sage.
Mearns, D. and Thorne, B. (1988) Person-centred Therapy Today: New Frontiers in Theory and
Practice. London: Sage.
96

The balance between


problems and solutions

Over the last decade, there has been a powerful movement within counselling and
psychotherapy away from a preoccupation with helping people to analyse their prob-
lems, and towards the goal of building up the persons strengths and skills, and helping
them to find practical solutions.
This trend is reflected in various approaches to counselling and psychotherapy,
ranging from the emphasis on personal growth that is found in humanistic therapies, to
the goal-oriented nature of behaviour therapy. However, it has found its clearest expres-
sion in solution-focused therapy and in narrative therapy.
This learning task gives you an opportunity to reflect on some of the implications of a
strengths-based approach to therapy.
Think about some specific situations where you have been involved in a counselling
relationship, trying to help another person. Think also about occasions when you have
been the recipient of counselling yourself.
In these situations:
G How much of the time was spent talking about problems, and how much time was
devoted to strengths and solutions?
G In what ways was it helpful for you (or the person you were helping) to talk about
the detail of their problems?
G In what ways was it helpful to talk about solutions (strengths, good news,
achievements)?
G What is your sense of the right balance between a problem focus and a solution
focus in the counselling episode(s) you have been looking at?
G What has made the difference for you at times when you have struggled with an
area of difficulty in your life: expressing and exploring your pain and distress, or
expressing and exploring creative ways of resolving your difficulties?
More broadly:
G What does a person gain by becoming aware of, and taking note of, their solutions
to problems?
G What can a person learn, or gain, from becoming aware of the possible causes of
their problems?
In considering these questions, what have you learned about your own position as a
counsellor in relation to the adoption of a solution-focused or problem-oriented
approach to working with clients?
Making sense: constructing a framework for understanding 97

Further reading
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(Chapter 8).
98

Specific techniques or
common factors

Over the last 50 years there has been a great deal of research that has compared the
effectiveness of different models of therapy. This research has arrived at an apparently
paradoxical conclusion: all approaches to therapy, no matter what their methods,
appear to yield equivalent results in terms of client outcomes. These findings have
stimulated debate over the role of common or non-specific factors in counselling and
psychotherapy.
A common factor is a therapeutic process that occurs in any kind of therapy. A
specific technique, by contrast, is an intervention that forms part of a particular, named
approach to therapy.
Consider the following lists of common and non-specific factors, and then respond
to the questions that follow:

Common factors Specific techniques


Encouraging the client to have positive expectations for Systematic desensitization (behaviour
change therapy)
The therapist being warmly and genuinely interested in Interpretation of dreams (psychoanalysis)
the client Two-chair dialogues (Gestalt therapy)
Offering a safe environment within which to talk about Empathic reflection of meaning (person-
shameful or difficult attitudes and experiences centred approach)
The counsellor having the status of a socially Counsellor congruence (person-centred) or
sanctioned, credible, healer use of counter-transference (psychodynamic)
Having permission to express emotion Writing a re-authoring letter to the client
Being offered a framework for understanding ones (narrative therapy)
problems Challenging irrational beliefs and destructive
Being introduced to a set of procedures or rituals that self-talk (CBT)
will bring about change Exploring the assumptions that inform ones
Observing at close hand a person (the counsellor) who worldview (philosophical counselling)
is skilful in dealing with relationships

Key questions for reflection:


G To what extent can the therapeutic impact of each of these specific techniques be
explained or understood in terms of the list of common factors in the left-hand
column?
G Are there any therapeutic processes associated with the specific techniques in the
right-hand column that cannot be reduced to common factors? How would you
describe or characterize these uncommon factors?
G What is your position on the relationship between specific techniques and com-
mon factors? What are the implications of this position for the way that you work
with clients?
Making sense: constructing a framework for understanding 99

Further reading
The common factors perspective is discussed on pages 35862 and 3713 of McLeod, J. (2009)
An Introduction to Counselling, 4th edn. Maidenhead: Open University Press.
100

Positioning your practice


in relation to social and
political factors
Counselling and psychotherapy have evolved as forms of help that typically operate at
an individual level. One of the most powerful critiques of contemporary counselling
comes from those who argue that it functions within society to promote an over-
individualized approach to problems that are in fact cultural, social and political in
nature.
This critique has led in two directions:
1 an argument that counselling/psychotherapy should be replaced by some form of
social and political activism;
2 attempts to make therapy more socially informed.
Take some time to reflect on, and write about, the following questions:
G Politics can be understood as referring to the way that different groups in society
exert power, influence and control to advance their own interests, and to ensure
that their own vision of the good life will prevail. In general terms, what is the role
of therapy and therapists in this process? Is therapy (or should it be) an activity that
stands outside the political arena? If it does not, then what is its role?
G What are the political factors that affect the lives of your clients, and the thera-
peutic process that you engage in with them?
G What do you actually do yourself (if anything) to address political issues in your
work with clients?
G What are your personal political beliefs and values? How do these beliefs and
values influence your work as a counsellor?
G How seriously do you feel that the social critiques you have read threaten the basic
mainstream approaches to counselling? Should these mainstream approaches be
abandoned? If they shouldnt be abandoned, do they need to be adapted or recon-
figured to take better account of social factors? How could this happen? How
might mainstream approaches to counselling change in order to become more
socially inclusive?
G What are the implications of these critiques for your own practice; for example, in
terms of your relationship with clients, the organizational setting in which you
might wish to work, and your theoretical model?

Further reading
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(Chapter 16).
101

The idea of the unconscious

It is part of everyday common-sense to admit that there are times when one is not
consciously aware of what one is doing, or why a particular action has been taken.
However, the notion of the unconscious, as used in psychoanalytic and psychodynamic
approaches to counselling and psychotherapy, goes far beyond this common-sense
view in assuming that the unconscious mind operates in a highly specific manner. Take
some time to read carefully, and reflect on, the following key passage, written by Freud
towards the end of his career:
. . . we call unconscious any mental process the existence of which we
are obliged to assume . . . but of which we are not directly aware. . . . We
call a process unconscious when we have to assume that it was active at
a certain time, although at that time we knew nothing about it. . . .
Psycho-analysis has impressed us very strongly with the new idea that
large and important regions of the mind are normally removed from the
knowledge of the ego, so that the processes that occur in them must be
recognised as unconscious in the true dynamic sense of the term. . . . The
id is the obscure inaccessible part of our personality . . . a chaos, a caul-
dron of seething excitement. We suppose that it is somewhere in direct
contact with somatic processes, and takes over from them instinctual
needs and gives them mental expression, but we cannot say in what
substratum this contact is made. These instincts fill it with energy, but it
has no organization and no unified will, only an impulsion to obtain
satisfaction for the instinctual needs, in accordance with the pleasure-
principle. The laws of logic above all, the law of contradiction do not
hold for processes in the id. Contradictory impulses exist side by side
without neutralising each other or drawing apart. . . . There is nothing in
the id which can be compared to negation, and we are astonished to find
in it an exception to the philosophers assertion that space and time are
necessary forms of our mental acts. In the id there is nothing correspond-
ing to the idea of time, no recognition of the passage of time . . . no
alteration of mental processes by the passage of time . . . impulses which
have never got beyond the id, and even impressions which have been
pushed down into the id by repression, are virtually immortal and are
preserved for whole decades as though they had only recently occurred.
They can only be recognised as belonging to the past, deprived of their
significance, and robbed of their charge of energy, after they have been
made conscious by the work of analysis, and no small part of the thera-
peutic effect of analytic treatment rests upon this fact. . . . Naturally, the
id knows no values, no good and evil, no morality . . .
(Freud, 1933: 93100)
102 The counsellors workbook

Is this a definition of the unconscious with which you agree? Does it fully capture the
way that you might wish to use this concept in your therapeutic work? If it does not
reflect the way you view the unconscious, then what kind of alternative definition
might you suggest? Is it possible to imagine conducting therapy without making any
reference to unconscious processes?

Further reading
These issues are explored further in:
Edwards, D. and Jacobs, M. (2003) Conscious and Unconscious. Buckingham: Open University
Press.
103

What brings about change?


The relative importance of
cognition and emotion
All theories of therapy acknowledge that the process of change involves an interplay of
cognitive factors (changing the way that the person thinks about an issue) and emotion
(e.g. expressing repressed feelings). However, theoretical approaches differ significantly
in the extent to which they emphasize one or the other of these key factors. For instance,
the cognitive therapies of Beck and Ellis regard cognition as primary, with emotions
being determined by the way that a person perceives or construes events. By contrast,
both psychoanalysis and person-centred counselling regard the inner emotional life, or
felt sense, of the person as the main driver of therapeutic change, and would view
changes in the way a person thinks about an issue as following from changes in the way
they feel.
What is your own position in relation to the relative importance of emotion and
cognition? Your own personal experience and belief in relation to this issue will inevit-
ably shape your choice of theoretical orientation.
Read through the descriptions of personal learning and change that you created in
response to some of the learning tasks in Section 2 of this Workbook. Are there any
recurrent themes in these descriptions concerning the relative importance of emotion
and cognition. Do your descriptions include mainly examples of cognitive insight and
understanding, or have you mainly written about moments of emotional release and
catharsis?
When reflecting on what this learning activity has produced for you, it may be
helpful to consider the following questions:
G What have you learned about the relative importance of cognitive and emotional
processes in your own way of understanding change in therapy?
G How well does your own take on cognition and emotion correspond to the
theoretical approaches that interest you, or with which you have identified
yourself?
G What is your own personal model of the links between cognition and emotion? In
your opinion, how do they link up what causes what?
G How long have you held these ideas about cognition and emotion? Where and
how did you learn them?
G What are the implications of your position on emotion cognition for your practice
as a counsellor?
104 The counsellors workbook

Further reading
Greenberg, L.S. (2002a) Integrating an emotion-focused approach to treatment into psycho-
therapy integration, Journal of Psychotherapy Integration, 12: 15489.
Greenberg, L.S. (2002b) Emotion-focused Therapy: Coaching Clients to Work Through their Feel-
ings. Washington, DC: American Psychological Association.
Oatley, K., Keltner, D. and Jenkins, J. (2006) Understanding Emotions, 2nd edn. Oxford:
Blackwell.
105

Behind the theory: the life of


the theorist

Theories of counselling and psychotherapy have tended to be associated with the ideas
of key figures, such as Sigmund Freud or Carl Rogers. These leading theorists are often
revered as brilliant thinkers, who transformed the field through their genius. However, it
is possible to view the importance of these individuals in a different light. Any theory of
therapy can be regarded as a set of ideas and assumptions that reflect the cultural milieu
within which they were generated. In important ways, the theories of Freud and Rogers
became influential because they somehow reflected and articulated aspects of human
experience that were challenging and significant in pre-World War I Europe (for Freud)
and in post-World War II USA (for Rogers). The popularity of a theorist can be taken as
indicating the extent to which his or her writings can operate as a channel for expressing
the distinctive personal and interpersonal issues being faced by a particular group of
people at a specific time in history. It is often pointed out that the childhood experi-
ences of theorists such as Freud and Rogers played a large part in shaping their ideas.
But, in important ways, these childhood experiences themselves may reflect broader
aspects of the culture within which the person grew up.
In becoming a counsellor or psychotherapist, it is essential to develop a theoretical
framework with which client issues, and the process of therapy, can be understood.
Inevitably, this theoretical framework will largely draw on the ideas of a small number
of influential writers and theorists. In order to gain a full appreciation of these theories, it
can be very useful to learn about the lives of the theoreticians themselves. To a large
extent, their theories evolved to enable them to make sense of issues within their own
lives, and in the lives of people they knew.
A useful learning activity is to make an effort to go beyond the kind of brief bio-
graphical snapshot that is provided in introductory textbooks, and read actual biograph-
ies of theorists who have had an influence on you. Although autobiographical writing
may be interesting and relevant, they are likely to be grounded in the worldview of the
author a good biographer should have the capacity to place the life and work of his or
her subject in a wider cultural context.

Further reading
Some biographies of therapy theorists that have been particularly well received include:
Cohen, D. (1997) Carl Rogers: A Critical Biography. London: Constable.
Gay, P. (1988) Freud: A Life for Our Time. London: Dent.
Kirschenbaum, H. (2007) The Life and Work of Carl Rogers. Ross-on-Wye: PCCS Books.
Shepard, M. (1975) Fritz. New York: Bantam Books (biography of Fritz Perls).
Two books that explore the personal and cultural influences on a number of important therapy
theorists are:
106 The counsellors workbook

Atwood, G. and Stolorow, R. (1993) Faces in a Cloud: Intersubjectivity in Personality Theory,


2nd edn. Northvale, NJ: Jason Aronson.
Magai, C. and Haviland-Jones, J. (2002) The Hidden Genius of Emotion: Lifespan Transformations
of Personality. Cambridge: Cambridge University Press.
107

The cultural context of


understanding

How does your cultural identity influence your choice of counselling approach in
relation to training and practice? The impact of the social, cultural and family environ-
ment on the ideas of mainstream therapy theorists has been widely documented. But
what are the ways in which your own social, cultural and family environment has
shaped your personal approach to counselling?
In the Exploring cultural identity activity, which was introduced in Section 1
(p. 29), you were invited to examine various aspects of your cultural origins and
experiences. Looking back at what you wrote in response to that activity, consider the
following questions:
G What are some of the values and beliefs that you associate with your cultural
background that seem most relevant to counselling?
G Imagine explaining your work as a counsellor, and the theories that you follow, to
your grandmother. Would she be interested? Would she think that what you were
doing was useful? What advice might she give you about how to be a better
therapist?
G Are there areas of tension in your cultural identity? For example, your mother and
father may have grown up in quite different cultures. Or were there times in your
life when you deliberately attempted to distance yourself from your culture of
origin? How has your awareness of these tensions informed your understanding
of counselling?
G Are there any rituals within your home culture that could be viewed as having a
psychotherapeutic function (e.g. confessionals in church, family meetings, pil-
grimages)? How might your engagement in such activities have informed your
thinking about counselling?
G Is counselling for you a means of reinforcing and supporting the core values of
your culture, or has it been a way of creating a new and different identity for
yourself?
The underlying issue here is linked to the view of Lomas (1999: 25) that a person
learning to become a counsellor needs to explore how best they can go about finding
their own way, using their own intuition, learning to be themselves in the presence of
someone who is asking for help. Does you theoretical framework express who you are,
including your sense of your own cultural identity?
108

What kind of therapeutic


relationship?

Counselling is fundamentally a relationship between two persons. There is a wealth of


evidence, from carefully conducted research studies and practical experience, that the
quality of the therapeutic relationship has a huge impact on the amount that the client
can gain from therapy.
However, relationships are difficult. We can all experience problems in making,
keeping and ending relationships. The challenge, in becoming a counsellor, of seeking
to be some kind of relationship expert is considerable. Clients may be seeking all sorts
of different kinds of relationship with their counsellor, and may create different kinds of
barrier to form a productive working alliance. In turn, the needs and relationship
patterns of the client may uncover gaps in the counsellors capacity to relate.
These activities are intended to enable exploration of the relationship issues and
challenges associated with counselling practice:
1 An experienced therapist, interviewed by Skovholt and Jennings (2004: 64),
described his way of seeing the relationship between counsellor and client in the
following terms:
One of the metaphors I often use with my clients is the metaphor of
the Wilderness Guide, and the way I put that is they can hire me as
a guide, because I know a lot about survival in the wilderness my
own, and Ive travelled through a lot of wildrenesses. Ive got a com-
pass, I can start a fire in the rain. I know how to make it through, but
this is a new wilderness to me. I havent been in this particular
wilderness before, and so I cant quite predict what were going to
encounter.
In An Introduction to Counselling (Chapter 14), other metaphors of relation-
ship found in mainstream approaches to counselling are discussed:
G therapist as container;
G therapist as authentic presence;
G therapist as teacher, coach or scientist;
G the not-knowing stance: therapist as editor.
Which of these images seem closest to the way that you experience yourself as
being, or would aim to be, when in the role of counsellor or psychotherapist?
What are the implications of each of these metaphors, both for you and the client?
2 Petruska Clarkson (1994: 42) argues that effective counsellors should be able to
relate to clients, if necessary, at a transpersonal level:
the transpersonal relationship is . . . characterised . . . by a kind of
intimacy and by an emptying of the ego at the same time. It is rather
as if the ego of even the personal unconscious of the psychotherapist
Making sense: constructing a framework for understanding 109

is emptied out of the therapeutic space, leaving space for some-


thing numinous to be created in the between of the relation-
ship. . . . It implies a letting-go of skills, of knowledge, of experience,
of preconceptions, even of the desire to heal, to be present. It is
essentially allowing passivity and receptiveness for which prepar-
ation is always inadequate . . . It cannot be made to happen, it can
only be encouraged in the same way that the inspirational muse of
creativity cannot be forced, but needs to have the ground prepared
or seized in the serendipitous moment of readiness.
To what extent is this form of therapeutic relationship meaningful for you? If it
seems to you to represent an important dimension of therapy, how might you
integrate this kind of possibility into your theoretical framework?
3 Return to the Mapping your relationship patterns exercise in Section 1 (p. 33).
What did you write in response to that set of tasks? Looking now at what you
wrote, what are the implications for your preferred ways of relating to clients?
What are the implications in terms of difficulties that you might experience in
relating fully to clients?
4 A wonderful book by Deborah Lott (1999) provides a rich account of womens
experiences of their relationships with their therapists. The idea for this book
arose from her involvement with a group of women friends who met regularly to
share their therapy war stories:
. . . it struck me that our exchanges resembled nothing so much as
accounts of love affairs. We felt the same urgent need to get every
detail straight, every word right. . . . We found the very structure of
the therapeutic relationship problematic. It was inherently unequal:
We needed our therapists more than they needed us, they were
much more important to us than we were to them. . . . To what extent
was this even a real relationship, and if it wasnt real, what exactly
was it? It wasnt friendship, and yet it was different from any other
professional relationship we had ever had (pp. 12).
Is this an account of the therapeutic relation that you recognize? If it is, what
significance does this perspective have for you in terms of your personal
approach?
In reflecting on these activities, it may be helpful to address the following questions:
G What is your image, or model, of the clientcounsellor relationship?
G Which theories or concepts do you find useful in making sense of the therapeutic
relationship?
G Are there aspects of the therapeutic relationship that, for you, seem to sit outside
the established theories?
G How would you want a counsellor to be with you?
G How do you want to be with clients?
110

Dialogue between theorists

In the process of building a theoretical framework through which you can make sense of
your work as a counsellor or psychotherapist, you will almost certainly discover that you
are drawn toward sets of ideas that are different from competing traditions, or hard to
integrate or reconcile with each other. It is valuable to regard such experiences as
opportunities for learning. If you find meaning in different theories, then they are (by
definition) meaningful for you. What may be lacking is a conceptual bridge or idea that
might enable you to see how the apparently conflicting ideas may be connected. This
learning task provides a technique that you might like to use to make such connections.

Dialogue between therapists


Choose two theorists whose work is important to you, but who seem to be saying quite
different things. (It is possible to carry out this exercise with more than two theorists, but
it gets more complicated.) Imagine that these theorists are in a room talking together, or
are in email contact with each other. They are being stimulated and interviewed (by
you) to engage in an exchange of views over some of their ideas. Write down this
dialogue. Allow the dialogue to flow the intention is not to come up with a version of
each therapists model that is necessarily factually accurate, but to begin to explore
what their ideas mean to you.
For example, you may be convinced by Carl Rogers ideas about the therapeutic
core conditions, and also interested in Erik Eriksons model of stages of psychosocial
development, but be at a loss to understand how they might fit together. Your imaginary
dialogue might look something like:

Interviewer: One of you has a very clearly worked out theory of development, but
the other Rogers seems to talk only about conditions of worth. How can these
perspectives be reconciled?
Carl Rogers: I always knew about Eriks ideas, but I didnt want to go down that
road. My fear was always that a too definite model of development would detract
from the clients frame of reference and impose a set of assumptions based on
the therapists theory, rather than the clients reality.
Erik Erikson: I share that fear. Thats why I always argued that these themes (iden-
tity, trust and so on) were in a sense always present even if they seemed to be
most prominent at certain ages. I always thought there were big connections to be
made between autonomy, initiative, trust and so on, and the way you talked about
empathy . . .
Carl Rogers: Yes, in a sense accurate empathy involves trust, and being separate,
and having a good sense of your own identity . . .
Making sense: constructing a framework for understanding 111

This is only a hypothetical example. Your own dialogue might take a very different
direction. Your protagonists may find they have a lot in common . . . or they may end up
shouting at each other!
When you read through the dialogue you have created, look for the connections that
have been made, and also for the new concepts that may act as bridges between the
two sets of ideas.
112

Are you postmodern?

According to many philosophers and social theorists, the closing years of the twentieth
century saw the beginnings of a shift in the pattern of the dominant culture within
Western industrial societies. The period from the 1700s to the mid-1900s can be
viewed, historically, as comprising an era characterized by the growth and consolida-
tion of a modern world in which rationality, science, individualism, consumerism and
the idea of progress were central to the way that people made sense of the world that
they lived in. Psychology, and then counselling and psychotherapy, have been integral
to the efforts of individuals to adapt to the demands of living in a modern society.
Theories of therapy, and the research that has backed them up, have for the most part
been formulated in accordance with the principles of modernity.
More recently, the ideas and social structures associated with modernity have
started to fragment, and to be replaced by a different form of understanding. This new
perspective has been described as postmodernity.
Some of the distinctive themes of postmodern thought have been described by
Steiner Kvale as:
. . . a loss of belief in an objective world and an incredulity towards
meta-narratives of legitimation . . . with the collapse of universal meta-
narratives, local narratives come into prominence. The particular, hetero-
geneous and changing language games replace the global horizon of
meaning. With a pervasive decentralization, communal interaction and
local knowledge become important in their own right . . . a postmodern
world is characterized by a continual change of perspectives, with no
underlying frame of reference, but rather a manifold of changing hori-
zons . . . language and knowledge do not copy reality. Rather, language
constitutes reality, each language constituting specific aspects of reality
in its own way. . . . Postmodern thought focuses on the surface. . . .
(Kvale, 1992: 327)
A postmodern perspective is suspicious of all-encompassing grand theories, such as
psychoanalysis and person-centred theory, and of any attempt to claim depth, in the
sense of an underlying fundamental truth. Instead, postmodern thinking is interested in
the way that realities are constructed through language.
To what extent do these ideas have meaning for you? If you are personally drawn to
postmodern thinking, what are the implications for your approach as a counsellor? If
you are not, what are the implications for your work with any client who does embrace
these ideas?
Making sense: constructing a framework for understanding 113

Further reading
Loewenthal, D. and Snell, R. (2003) Post-modernism for Psychotherapists: A Critical Reader.
London: Brunner-Routledge.
Polkinghorne, D.E. (1992) Postmodern epistemology of practice, in S. Kvale (ed.) Psychology and
Postmodernism. London: Sage.
114

Letter to a theorist

One of the techniques that is used in both personal journal writing, and in some forms
of narrative therapy, is to compose a letter to a person with whom one would like to
have a discussion, but who is not actually available to talk with. In bereavement work,
for example, a person may write a letter to the person who has died. The value of an
unsent letter is that it can provide an opportunity to get thoughts and feelings out into
the open, and to begin, through a process of writing, to bring some order and structure
to them.
This exercise invites you to make use of this technique to advance your understand-
ing of theoretical issues in counselling.

Learning activity
Write a letter to a theorist who has some significance for you in terms of the way you
make sense of counselling. Give yourself permission to write anything you wish to the
person what you like or do not like about his or her ideas, aspects of their thinking that
make you angry or frustrated, questions that you have, counter-arguments, requests for
help, compliments, invitations, and so on
It may be useful to consider different occasions that might call for such a letter:
G a theorist that you have just come across;
G a theorist who is a major influence on your thinking;
G a goodbye letter to a theorist whose influence on your thinking you are trying to
reduce or eliminate.
Once you have written the letter, reflect on what you have learned about yourself, and
your theoretical stance as a counsellor or psychotherapist.
Further related activities might include:
G writing letters to other theorists;
G writing a letter to yourself as a theorist;
G writing a letter from one of your clients to a theorist who has influenced and
informed your work with that client;
G storing these letters, and rereading them at some time in the future, as a means of
tracking the development of your theoretical interests and concerns.
115

The concept of transference

The concept of transference represents one of the key ideas within contemporary coun-
selling and psychotherapy. Most counsellors and psychotherapists will acknowledge
that clients may express strong feelings both positive and negative towards them.
The existence of powerful and persistent client reactions to therapists is not disputed.
However, there are major disagreements over the meaning and significance of such
emotional responses. From a psychoanalytic or psychodynamic perspective, these
reactions are indicators of patterns of early experience. From a person-centred or
humanistic perspective, by contrast, these responses are understandable in terms of the
here-and-now relationship between client and counsellor, often arising from the efforts
of the counsellor to understand the client. These opposing positions are captured in the
following passages from Sigmund Freud, and from a leading person-centred theorist
and researcher, John Shlien:
The patient is not satisfied with regarding the analyst in the light of
reality as a helper and adviser who, moreover, is remunerated for the
trouble he takes and who would himself be content with some such role
as that of a guide on a difficult mountain climb. On the contrary, the
patient sees in him the return, the reincarnation, of some important figure
out of his childhood or past, and consequently transfers on to him feel-
ings and reactions which undoubtedly applied to this prototype. This fact
of transference soon proves to be a factor of undreamt-of importance, on
the one hand an instrument of irreplaceable value and on the other hand
a source of serious dangers. This transference is ambivalent: it comprises
positive (affectionate) as well as negative (hostile) attitudes towards the
analyst, who as a rule is put in the place of one or other of the patients
parents, his father or mother. So long as it is positive it serves us admir-
ably. It alters the whole analytic situation; it pushes to one side the
patients rational aim of becoming healthy and free from his ailments.
Instead of it there emerges the aim of pleasing the analyst and of winning
his applause and love. It becomes the true motive force of the patients
collaboration; his weak ego becomes strong; under its influence he
achieves things that would ordinarily be beyond his power; he leaves off
his symptoms and seems apparently to have recovered merely for the
sake of the analyst. The analyst may shamefacedly admit to himself that
he set out on a difficult undertaking without any suspicion of the extra-
ordinary powers that would be at his command.
(Freud 1938)

Transference is a fiction, invented and maintained by the therapist


to protect himself from the consequences of his own behavior. . . .
Dependency is a built-in feature for the (client) at the beginning, and the
116 The counsellors workbook

treatment itself often promotes further dependency. The patient (or client)
is typically anxious, distressed, in need of help, often lonely. The therap-
ist, presumably, is not. Instead, he holds a professional role (especially if
a physician) that ranks at or near the top in sociological surveys of roman-
tic attractiveness to women seeking husbands (ahead of astronauts and
other celebrities). The situation is set for intimacy, privacy, trust, frequent
contact, revelation of precious secrets. Second, it is also the case that
there is an ongoing search, on the part of most adolescents and adults, for
sexual companionship. It requires only the opportunity for intimacy. One
does not need to look into therapy for arcane and mysterious sources of
erotic feelings. They are commonplace, everywhere, carried about from
place to place. Psychotherapy will encounter sexual attraction as surely
as it encounters nature. The simple combination of urge and situation is
a formula for instant, if casual, romantic fantasy. . . . Third, there is a
supremely important special factor in a behavior to which all therapists
subscribe and try to produce. It is understanding. Freud bluntly put it, (of
transference) it is a kind of falling in love. Let me put this bluntly too:
understanding is a form of love-making. It may not be so intended, but
that is one of its effects. . . . In this same context, misunderstanding is a
form of hate-making. It works equally well since being misunderstood in
a generally understanding relation is a shock, betrayal, frustration.
(Shlien 1984)

Learning task
Read through these two passages, and decide which of these statements best reflects
your own understanding and experience. Do you find some validity on both positions?
If so, how would you seek to integrate or reconcile these different points of view? What
are the implications, in terms of how a counsellor might work with a client, of the
transference and counter-theory perspectives?
Putting theory to
use: thinking
about cases

Section contents
Introduction 119
Student counselling: the case of Ms B 120
A clients opening statement 122
Cynthia: making life choices 124
The case of Glenys first session 126
The case of Glenys later sessions 128
I hear these voices telling me what to do 130
A case of work stress 132
Thelma: a victim of therapist boundary violation 133
Geoffrey: deconstructing demons 135
The case of Mrs Y 137
Charles: therapy as a last resort 139
The case of Ida 141
Anna: moving on in life 143
Case scenarios for working with emotions 145
David: tackling self-blame 146

117
119

Introduction

This section of the Workbook includes some case scenarios, describing clients who are
making use of counselling or psychotherapy services. With each of the cases, you may
find it useful first of all to respond on the basis of your own intuitive or personal
reactions and thoughts. Try to imagine that you are the therapist to each of these clients,
and do your best to enter into the imaginary situation that is depicted.
After you have written down you own personal response to the case, then you may
find it helpful to look at it from the vantage point of theoretical perspectives that interest
you: psychodynamic, cognitivebehavioural, person-centred, feminist, systemic, narra-
tive, transactional analysis, and so on. Once you have worked through how you might
make sense of the case from alternative theoretical standpoints, you are ready to con-
sider a number of questions that are highly relevant to the task of developing your own
personal approach as a counsellor:
G Which of the alternative analyses of the case seemed most helpful? Why?
G Which of the alternative analyses of the case seemed least helpful? Why?
G Which theoretical model, or combination of models, seemed to fit most closely
with your own personal reading of the case?
G What do your answers to these questions say about you, and what you stand for as
a therapist?
It is possible to expand your awareness of both theoretical and practice issues by work-
ing on these case studies on your own. However, it can also be illuminating to discuss
the cases in the context of a peer learning group. It is probable that, in a group, you may
find that your awareness of the issues presented by each of the case study clients may be
significantly expanded, as different members of the group introduce their own percep-
tions, sensitivity and experience. This kind of group discussion can give a sense of what
can happen in good supervision. What you may also find, however, is that you become
more aware of the reality that each practitioner seems to make use of a somewhat
limited palette of assumptions and emotions when responding to clients.
Several of the cases in this section are taken from published sources, reflecting
the work of a range of well-known master therapists. Once you have arrived at your
own formulation of the case, you may find it interesting to track down the original
publication, and find out what really happened to each of these people.
120

Student counselling: the


case of Ms B

Ms B is 24, single, and a university student in the final year of a social science degree.
Throughout the course she has felt frustrated at the grades she has received, which have
averaged around 5055 per cent. Now, having returned in October, she finds herself
worrying about her grades so much that she goes to the student counselling service.
At the first meeting, the counsellor asks her to talk about what the problem is, and
about the important things in her life that she feels might be associated with it.
The main points that emerge are:
G just feels herself to be a complete failure;
G she was the oldest of four children, and always felt under pressure to do well at
school;
G was close to her grandmother, who died when she was 16 she describes this as
the worst moment in my life;
G she did not feel that she got enough support or encouragement from her parents,
particularly when she did her university entrance exams;
G the thought of going home to live with her parents after the degree is scary;
G she failed to get good grades in her university entrance exams, and worked in a
shop for a year before doing an Access to University course at a community
college;
G she is lonely, with no friends or boyfriend. Finds it difficult to talk to her
flatmates;
G has no idea what she is going to do after graduating. When asked what her ideal
job would be, she pauses for several seconds and then answers that she would like
to be a trainee manager with a large supermarket chain, but that she has no hope of
getting a good enough degree for that, and anyway they only take really confident
types;
G sees herself as overweight and eats too much chocolate;
G avoids writing essays. Spends a lot of time reading novels rather than doing
academic work;
G gets very anxious when she starts work on an essay, which makes it difficult to
concentrate;
G it is difficult to ask tutors what is wrong with her essays;
G only speaks in seminars when explicitly asked a question;
G she is critical of some tutors for being unfair in their marking and not making sure
that books are in the library;
G when asked what her aim is for counselling, and what she would like to change,
she first says that she is not sure, then after a few moments adds: I guess the biggest
Putting theory to use: thinking about cases 121

thing is being afraid of other people . . . I just feel as if everyone is going to criticize
me . . . I can never relax with anyone;
G the counsellor notices that Ms B seems distant and talks about herself in a detached
manner;
G throughout the session, Ms B uses metaphors and images associated with fighting,
such as It was a battle to get to University, and I retreat into my bed with a carton
of ice cream;
G at the end of the session, the counsellor is aware of a strong feeling of sadness, and
of wondering whether Ms B would come back for another session. The counsellor
wondered whether he or she had somehow not been good enough for Ms B, and
may have let her down in some way.
Consider the following questions:
G What are the main issues that Ms B is bringing to counselling?
G How would you describe the way that Ms B relates to the world? What kind of a
world does she inhabit?
G Why now? What is the possible significance of choosing to visit the counselling
service at this time?
G If you were her counsellor, what else would you be interested in knowing about Ms
B in future sessions?
G How would you work with Ms B? What would you be trying to do?
G How many sessions do you think Ms B would need? On what basis do you make
this estimate?
G What might be the significance of the counsellors emotional response to Ms B?
122

A clients opening
statement

What a person says first, at the beginning of their initial counselling session, can often
encapsulate the key issues for which he or she is seeking help. It is important as a
counsellor to be able to tune in to a client from their first words.
The following statement was made by a young black man at the start of his first
counselling session:

I was sitting in the room and waiting beforehand and I was thinking
about why I was about seven or eight years old and I remember reading a
book I believe I cant recall the name of this book by Jung, I think it was
and I recall when I was reading that that at that time I used to go down the
basement of my home and turn off all the lights and in a way that was
kind of closing the outside world and concentrating on what I wanted to
do and what I wanted to be. And at seven years old I was I was into that
and today I am in the same position really, you know, trying to find out
what I want to do, what I want to be and Ive learned a lot of things. Ive
learned a lot of things since I found out that I had leukemia which is
about a year ago this June and I learned an awful lot of things . . . I think
that Ive listened for so long to other people about who I was and I
remember in second grade I was a potential credit to my race that was
one of the . . . I would always wonder why I couldnt be a credit to
somebody elses race also but I think I really conditioned to be some-
thing, to be some kind of a symbol or whatever and not really being a
person you know I kind of missed out on my childhood to an extent you
know I dont really regret it, I dont think I regret it anyway but Ive really
been through a lot of changes and I think that now after finding out I had
the leukemia and after dealing with the leukemia in the way I did its just
really incredible, you see it was last June when I found out and I pro-
ceeded to get everything in order because I was told that I had less than a
year to live and that was a trip and that was a trip and . . . and on one
hand you know I accepted the death, you know at my young age I think I
have lived long and a great deal but that was the start of some things that
err that really has had an affect on me today like I am much happier than I
have ever been today, I am much happier, but theres some theres a lot of
hurt to . . . theres an awful lot of hurt and I think I am just beginning to
realize that. Because, you know, in being a credit to your race in being an
outstanding student, an outstanding scholar, an outstanding football
player whatever leaves you little room to to be. . . .

Consider the following questions:

G What feelings, emotions and images does this opening statement trigger in you?
Putting theory to use: thinking about cases 123

G What is your sense of the key themes and issues in what this person is presenting?
G What would you say to this person at this point?

Further reading
This statement is taken from a case of Carl Rogers, filmed in 1977, and widely available on video.
As with many of Rogers recorded cases, the process of his work with this client has been sub-
jected to careful analysis. A book containing a series of responses to this case, from a range of
different writers, can be found in:
Moodley, R., Lago, C. and Talahite, C. (2004) Carl Rogers Counsels a Black Client: Race and
Culture in Person-centred Counselling. Ross-on-Wye: PCCS Books.
Other cases involving Rogers are examined in:
Farber, B.A., Brink, D.C. and Raskin, P.M. (eds) (1996) The Psychotherapy of Carl Rogers: Cases
and Commentary. New York: Guilford Press.
124

Cynthia: making
life choices

Cynthia was 32 years of age, a successful mathematics lecturer in a community college.


For several months she had felt anxiety and worry, which interfered with her ability to
concentrate. In addition, she felt depressed. In her first meeting with a counsellor, she
said that:
G She had grown up in a happy, conventional family environment, with her mother
(a housewife), father (businessman) and two brothers. Her brothers now had
successful professional careers, and were both married with children.
G She described her current partner, Fred, as solid and sensible; he wanted her to
marry him, give up her job and have children.
G She had only one previous serious boyfriend, at college her preference was to
work and study, rather than socialize.
G The biological clock was ticking soon she would be too old to have children
the recent birth of a new baby to one of her brothers had acted as a signal to her.
Also, she felt that she would let down her parents if she did not have a child.
G Cynthia did not want to give up her job; on the contrary, her goal was to go back to
university to do a Ph.D.
G She was not sure if she really wanted to have a child at all.
G Cynthia was uncertain about her sexuality she had recently had a six-month
affair with Martha, a fellow tutor at the college. Martha had become involved with
someone else; Cynthia had not moved on from this loss, and had met Fred soon
afterwards.
Cynthia believed that counselling would be more helpful for her than medication or
cognitivebehavioural therapy, because what she was looking for was a chance to talk
through the life choices that confronted her, and in particular to find a way to handle the
strong feelings of approval/disapproval that she felt from her mother and father.
G What are the main issues that Cynthia is bringing to therapy?
G How would you describe the way that Cynthia relates to the world? What kind of a
world does she inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at this
time?
G If you were her therapist, what else would you be interested in knowing about
Cynthia, in future sessions?
G How would you work with Cynthia? What would you be trying to do? What
techniques or strategies might you employ?
G What are Cynthias strengths?
G How many sessions do you think Cynthia would need? On what basis do you
make this estimate?
Putting theory to use: thinking about cases 125

G What feelings are triggered in you by listening to Cynthias story? What might be
the significance of this emotional response?

Further reading
A detailed account of this case can be found in:
Bohart, A.C. (2006) The client as active self-healer, in G. Stricker and J. Gold (eds) A Casebook of
Psychotherapy Integration. Washington, DC: American Psychological Association.
126

The case of Glenys first


session

You are working as a counsellor in a GP practice. One of the GPs refers Glenys to you.
She has been making appointments to see the GP every week for more than two years,
complaining of pains in her gut, and breathing difficulties. Glenys has been sent for
extensive tests and specialist consultations, but no physical causes for her symptoms
have been identified. The GP suggested that it might be helpful for Glenys to see the
practice counsellor. The practice offers clients 6 sessions of counselling, with an exten-
sion to 12 sessions with the permission of the GP. It has taken several weeks to find an
appointment time that is suitable for Glenys. During this period she has continued to
visit the GP.
Glenys is 45 years of age. She is married with two children. Before her marriage, she
worked as a care assistant in a home for the elderly. She took some time off when the
children were small, and then returned to work. After gaining some qualifications, she
now has a demanding job as the manager of a residential unit for people with learning
difficulties.
At the first counselling session, Glenys walks into the room slowly, and doubled
over, as if appearing to be in some pain. She is slightly built, and neatly dressed. She
immediately engages in conversation, and starts to tell you about the various medical
tests she has undergone, and complementary therapies that she has tried out. She comes
over as a very positive person, who is determined to get to the bottom of these health
problems. It is difficult for you to get a word in edgeways. She talks quickly, and repeats
the same information at different points in the session.
When asked about the situations that seem to bring about her symptoms, Glenys
replies that both the pain and breathing difficulties are around most of the time, except
when she goes to Spain on holiday. When asked about the worst recent episodes, she
describes a couple of occasions at work, when she has had to deal with difficult staff
meetings, and ended up needing to go home because she felt so bad.
You invite Glenys to talk about her relationship with her husband and children. She
describes these as wonderful: they are such a help to me. She describes in some detail
the accomplishments of her children, and the qualities of her husband: he is a rock.
She uses very few feeling words. She does not mention ay members of her extended
family during this first session.
Towards the end of the first session, you talk to Glenys about what counselling will
involve. She vehemently denies that she is mentally ill, or that there is any psycho-
logical side to her difficulties. She insists that what she needs is better pain manage-
ment, or a surgical intervention. You explain that many people find it stressful to live
with pain and other symptoms, and that counselling may help her with this. She replies
stating that I will try anything that might help.
Your impression of Glenys in this first meeting is of someone who is presenting a
nice face to the world, but who is concealing sides of herself that are perhaps not so
nice. You have a slight feeling of irritation, which you wonder might be the result of
Putting theory to use: thinking about cases 127

being forced to be a passive audience to Glenyss high-speed monologues. You also


have a sense of needing to handle her carefully.
Consider the following questions:
G What theoretical approaches might help you to make sense of the information you
have about this client?
G What approach might you take with Glenys?
G What are the themes and issues that you might potentially wish to explore
with her?
G What might be the challenges involved in developing a relationship with this
woman?
G Are there any counselling methods or techniques that might be particularly rele-
vant or effective?
Further progress of this case is described on the following page. It is recommended that
you respond to the questions on this page before reading about what happened next.
128

The case of Glenys later


sessions

In sessions 2 and 3, Glenys talked at length about the situations in which her pain and
breathing difficulties occur. Your impression is that she has thought deeply about the
question you asked in the first session, and is perhaps trying to please you, or conform
to your expectations, by working hard on this task.
At the start of session 4, she excitedly tells you that during the previous week, she
had experienced a moment of really bad breathing difficulties. She describes a staff
meeting at work, where all the care staff and domestics were together to hear about
some new arrangements about overtime payments and holidays. Some of them had
become very angry, and directed their anger at her, even though her boss, the divisional
manager, had also been present.
At one point I had to sit down, because I thought that I was going to
have a heart attack. I was breathing very quickly, like it was out of con-
trol. My arms were sort of numb and tingly at the same time. I thought I
was going to choke or faint. Everyone was very good. They told me I had
been under a lot of stress, and brought me some water, and then the
meeting went ahead. But I felt extremely shaky all day.
After saying this, Glenys quickly moves on to give her account of other situations during
the week that had been associated with symptoms.
You feel convinced that the episode at the staff meeting was a panic attack.

Task for reflection


How might you work with these further developments on Glenyss life? What could
you do to explore the meaning and experience of the panic attack for Glenys? Would
you want to offer information or strategies that would help her to cope with such
situations in future?

Session 7
Glenys was very pleased with the work you did together over the panic attacks: it has
made a huge difference. She fed this information back to the GP, who was very happy
to agree to a further six sessions.
At the beginning of session 7, Glenys seems very agitated, and almost tearful. She
begins to describe an occasion the previous day when she and her husband disagreed
over how to respond to a demand from one of their children.
It was like a knife in my gut. Very painful, I had to take three of my pills.
He just wasnt listening to me. He seemed too sure of what was right, and
Putting theory to use: thinking about cases 129

wouldnt allow me to get a word in at all. I felt like my tummy was really
bloated and almost exploding. It was sort of the same as the pain that is
usually there, but much more intense, and focused on one place. Later
on I developed a headache and had to go to bed. I tried some yoga
exercises, but it didnt do much good.
Your immediate sense is that Glenys has told you something that is very important, for
her and for your relationship. You feel closer to her. It is the first time that she has ever
been even slightly critical of her husband.

Task for reflection


What could you do to explore the meaning and experience of this pain episode for
Glenys?

Session 11
Glenys is very aware that the counselling sessions have come to an end. You have
referred her to the local NHS psychotherapy service, and she is on their waiting list
(average waiting time: 15 months).
Up until now Glenys has talked almost entirely about events that have taken place
within the last year. Today, she comes in and tells you that she has visited her fathers
grave. She had not mentioned her father before.
I dont know why I did it. I was just driving past the cemetery and the
idea came to me. It was only when I found the headstone that I realized
that it was virtually the anniversary of his death. I was only 12 when he
died [tears]. He had been in trouble with some financial business at his
work, and died in a car crash, It must have been suicide, but no-one
ever talked about it. It was good to stand there on the hillside and just
remember a few things about what he was like. He was a great dad [more
tears]. He used to take me to gymnastics, even to competitions in
England. I was so much into sport, it was what I wanted to do with my
life. He was always around. My life was never the same afterwards. My
mother needed so much help.

Task for reflection


How might you work with this story? How might you respond to what Glenys has said?
Finally, look back at all of your responses to the Glenys case:
G What are the therapeutic ideas and strategies that you have used in relation to your
hypothetical work with this person?
G What does your sense of how you might work with this client say to you about your
theoretical position as a counsellor?
130

I hear these voices telling


me what to do

You are a counsellor working with a voluntary sector agency, which offers open-ended
weekly counselling sessions to people with a wide variety of problems. There are no
assessment screening or intake interviews the client phones up and makes an
appointment, and the counsellor is the first person in the agency that they talk to.
Gary is in his mid-20s. He is neatly dressed, and seems rather nervous when he
enters the counselling room. He walks to his chair slowly and deliberately, and does not
engage in eye contact. When you ask him to say what has brought him to counselling,
he replies:
I hear these voices telling me what to do. Its getting so bad that my
brother told me that I need to get some help.
When invited to say more about what is happening in his life as a whole, it emerges that
Gary lives at home with his parents. He mentions several times that he has a predictable
routine, which he does not like to change. He has had a clerical job for many years,
which involves minimal contact with the public. Recently, he has felt stressed out by
his fathers illness (he has been diagnosed with cancer). It seems as though the family
dynamic has started to change Gary has found himself being required to take a more
active role in supporting his mother. He does not mention the voices again, and you do
not ask him about them.
Gary has a needy way of talking, and is highly sensitive, almost suspicious, about
any suggestions or questions that you put to him.
Throughout the session, you have a sense of walking on eggshells, and being very
careful to go at Garys pace. At the end of the counselling session, you agree to see Gary
again. You feel uncertain about how best to make sense of what happened in the
session, and wonder about the significance of these voices.

Learning tasks
G What are the main themes or issues that this client is expressing?
G What therapeutic ideas and strategies might you find helpful in relation to your
hypothetical work with Gary?
G How would you approach the issue of the voices?
G How might you negotiate a therapeutic contract with this client? What would you
want to include in the contract?
G What does your sense of how you might work with this client say to you about your
theoretical position as a counsellor?
Putting theory to use: thinking about cases 131

Further reading
Romme, M. and Escher, S. (1993) Making Sense of Voices. London: Mind.
132

A case of work stress

You are working as a counsellor for an Employee Assistance Programme (EAP), which
has a contract to provide brief (six-session) counselling for staff of a major national
financial services company.
Jeff (27) makes an appointment to see a counsellor. He tells you that he saw his GP
earlier in the week about his depression. All the GP offered was pills, so Jeff decided to
try the company EAP. He tells you that he has had a successful career as an IT analyst.
He has a good salary and owns his own flat in town. He describes himself as devas-
tated because his partner of five years Rita has suddenly left him to move in with
another man.
In a flat tone, he responds to your question about how he feels:
I just keep thinking about it. I cant go to work at all. In fact I cant do
anything but sit in the flat playing records and looking at photo albums.
I dont want to speak to anyone. My parents, my brother, my best friend,
have all been round to see me but I pretend I am not in. I feel hurt and
betrayed and angry and depressed all at the same time. Some of the time
I think that if I cant have her, then no-one should have her. I feel like
ending it all. I feel so worthless and tired of this nightmare that I wish I
could just go to sleep forever and forget about it all. It would be all over. I
know that things werent going too well between us. She kept telling me
that I was locked up in my work and always seemed tired and irritable.
But I had no idea that it could have been that bad. The company has been
going through a merger, and its like everyone has two jobs at least to do.
Its not the sort of place that you want to be first out of the car park at 5.

Learning task
G How might you feel at this moment? How might you respond? What would
you say?
G What themes and issues might you want to explore further?
G How might you structure the remaining 30 minutes of the session?
G Which theoretical models or techniques might be helpful in your work with this
client over the remaining five sessions?
Finally:
G What have you learned, in thinking about your response to this case, about
yourself as a counsellor?
G What does your sense of how you might work with this client say to you about your
theoretical approach?
133

Thelma: a victim of
therapist boundary violation

At the time of entering therapy, Thelma was 70 years of age. She had been married to
Harry for more than 40 years. Although his career in the navy had taken him away from
home for long periods, there was little closeness in their relationship. Since retiring from
the navy, Harry had taken a senior position with the Boy Scout movement, which
involved regular travel to inspect Scout groups in distant parts of the country.
Thelma had enjoyed a successful career as a dancer. Since the age of 50, when her
dance career had come to an end, she had become depressed, and had been continu-
ously in psychiatric treatment, receiving therapy from a series of trainee psychologists
at a community mental health clinic, as well as regular episodes of antidepressant
medication.
At her first appointment, Thelma looked haggard and unkempt, wearing a baggy
jogging outfit and thick coat. At the start of the session, she clearly stated her goal for
therapy:
Eight years ago I had a love affair with my therapist. Since then he has
never left my mind. I almost killed myself once, and I believe I will
succeed the next time. You are my last hope of finding a way to live with
at least a little happiness.

In the remainder of that first session, Thelma talked about what had happened. Matthew
had been in the final stage of his training when he took Thelma on as a client at the
community mental health centre. She described him as the first therapist who had ever
made a difference to her. He was in his early 30s, caring and affirming, and also
challenging. He had introduced her to spiritual ideas that had become important for
her. When he completed his training internship at the centre, and went into private
practice, Thelma had followed him and remained his client for another 12 months.
Their therapy contract ended when he took a job in a hospital, and was no longer able
to see private clients. Their relationship throughout this period of therapy had been on a
purely professional basis, with no contact outside of their regular therapy sessions.
One year after the end of therapy, she bumped into Matthew in the city. He was
interested in what had happened for her in the year since they had last met, so they had
coffee and talked. Their conversation stretched on into the evening, so they had dinner
together. Following this, they went to Matthews apartment and made love. Their affair
continued for the next month, until ended by Matthew. The ending was devastating
and unbearable for her. She became obsessed by him, and phoned him every day.
Eventually, she made a serious suicide attempt. Matthew visited her in hospital but was
cold and professional, and stayed for only 15 minutes.
Over the following eight years, Thelma had become increasingly depressed, spend-
ing most of her time thinking obsessively about Matthew what had happened, why it
had ended, how she could get him back. She had seen a number of therapists, but had
not told any of them about the affair. She explained that she had decided to see you as a
134 The counsellors workbook

last hope, because you were older and more experienced if anyone could help her, it
would be you.
G What are the main issues that Thelma is bringing to therapy?
G How would you describe the way that Thelma relates to the world? What kind of a
world does she inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at
this time?
G If you were her therapist, what else would you be interested in knowing about
Thelma in future sessions?
G How would you work with Thelma? What would you be trying to do? What tech-
niques or strategies might you employ?
G What are Thelmas strengths?
G How many sessions do you think Thelma would need? On what basis do you make
this estimate?
G What feelings are triggered in you by listening to Thelmas story? What might be
the significance of this emotional response?

Further reading
This case is described in more detail in:
Yalom, I.D. (1989) Loves Executioner and Other Tales of Psychotherapy. London: Penguin.
135

Geoffrey: deconstructing
demons

Geoffrey was a divorced African American man, 66 years old, unemployed (working
voluntarily in a centre for older people), and living alone in a small, one-room apart-
ment in a city in the Northeastern USA. At his assessment interview, Geoffrey told the
following story:
G grew up in a small town with both parents and one brother;
G attended university for two years, to study English, but dropped out because of
examination anxiety;
G an avid reader;
G had served in the Vietnam War, in a non-combat administrative role;
G had been married with three daughters (now estranged);
G politically active in the 1980s and 1990s but had stopped because people made
him nervous;
G recent 5-year period of heavy drug use, ending 3 years previously (also previous
10-year history of misuse of alcohol, marijuana and crack cocaine);
G held a series of administrative jobs until addiction led to loss of employment;
G built up substantial credit card debts during period of drug misuse; currently living
on benefits;
G during drug phase, started seeing other women. One female fellow addict died of a
drug overdose in bed with him;
G this event resulted in his divorce, and rejection by his family;
G event also triggered post-traumatic stress disorder symptoms: flashbacks, hyper-
vigilance, mistrust of people and emotional numbing;
G ex-wife died three years later of cancer they had never resolved the issues
between them;
G in good physical health other than high blood pressure and type II diabetes (was
not adhering consistently to the recommended diabetes self-care guidelines);
G smoked 10 cigarettes per day, but no alcohol intake;
G had successfully completed two 28-day inpatient detoxification programmes; had
been clean for 3 years.
Geoffrey described himself as depressed, and reported low motivation, lack of energy,
feelings of worthlessness and inappropriate guilt, trouble concentrating and making
decisions, and thoughts of his own death. He had cut out most activities over the past
year. He also ruminated obsessively about events from the past, and had a short atten-
tion span. He said that his brain was dead and that he felt like a very old man. He
spent most of his time watching television, which he believed prevented loneliness.
He believed that his symptoms had become worse over the last two months, and that his
136 The counsellors workbook

apartment had begun to make him uncomfortable for reasons he was not able to
articulate. Geoffrey viewed himself as a worthless, insecure failure. He felt that the
events of his life caused him to always aim low.
Geoffrey acknowledged that he almost always felt anxious when interacting with
unfamiliar people, because he felt sure that they were secretly judging him on the basis
of his previous mistakes. He also reported severe claustrophobia, which had started as a
young adult, and had grown worse over the years. He was unwilling to ride in elevators,
and disliked small, hot rooms. During the assessment interview, he showed signs of
difficulty in concentration, and was readily distracted by any external noises. He had
read about cognitivebehavioural therapy, and thought that it made a lot of sense.
Geoffrey stated that his goals for therapy were to overcome anxiety and depression,
fill his life back up, increase his levels of social, intellectual, and occupational
functioning, and feel better about himself.
G What are the main issues that Geoffrey is bringing to therapy?
G How would you describe the way that Geoffrey relates to the world? What kind of
a world does he inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at this
time?
G If you were his therapist, what else would you be interested in knowing about
Geoffrey in future sessions?
G How would you work with Geoffrey? What would you be trying to do? What
techniques or strategies might you employ?
G What are Geoffreys strengths?
G How many sessions do you think Geoffrey would need? On what basis do you
make this estimate?
G What feelings are triggered in you by listening to Geoffreys story? What might be
the significance of this emotional response?

Further reading
A detailed account of this case can be found in:
Mohlman, J., Cedeno, L.A., Price, R.B., Hekler, E.B., Yan, G.W. and Fishman, D.B. (2009) Decon-
structing demons: the case of Geoffrey, Pragmatic Case Studies in Psychotherapy, Volume 4,
Module 3, Article 1, pp. 139, www:pcsp.libraries.rutgers.edu.
137

The case of Mrs Y

Mrs Y was an attractive woman in her early 60s, who had enjoyed a successful edu-
cational and professional career. At her first session, she described her life in these
terms:
G She had been brought up in a prosperous middle-class setting: emotional poverty
in the midst of material luxury she had almost no happy memories of childhood.
G A middle child an older brother who was brain-damaged at birth, and a younger
sister.
G She perceived her mother as being caught up with her own needs and troubles,
and favouring her siblings.
G Her mother seldom touched her.
G A frequent childhood nightmare had been: my mother is watching indifferently
from the porch of our house while I was run down by a laundry truck in the
driveway.
G She had adored her father, but he was usually preoccupied with business.
G Her father would look after her when she was ill.
G Her father was prone to attacks of sudden rage.
G When Mrs Y was eight years old, her father became ill, and was bedridden at home
for six years until his death.
G Mrs Y was not allowed to disturb her father during his illness; after his death, all
emotion was denied in the family.
G She had never felt that she could make anyone happy.
G A few years before, her husband had an affair and had left her.
Mrs Y had been in therapy before (with little success), and described her goals for
therapy at this time as overcoming her depression, and becoming able to develop
better relationships she always had the sense that she was holding something back in
relationships, leaving her with a sense of loneliness.
G What are the main issues that Mrs Y is bringing to therapy?
G How would you describe the way that Mrs Y relates to the world? What kind of a
world does she inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at this
time?
G If you were her therapist, what else would you be interested in knowing about
Mrs Y in future sessions?
G How would you work with Mrs Y? What would you be trying to do? What
techniques or strategies might you employ?
138 The counsellors workbook

G What are Mrs Ys strengths?


G How many sessions do you think Mrs Y would need? On what basis do you make
this estimate?
G What feelings are triggered in you by listening to Mrs Ys story? What might be the
significance of this emotional response?

Further reading
A detailed account of this case can be found in:
Kalsched, D. (1996) The Inner World of Trauma: Archetypal Defences of the Personal Spirit.
London: Routledge (pp. 1928).
139

Charles: therapy as a
last resort

Charles was a student on a university Masters course in business administration. He


looked older than his age of 28, with prematurely grey hair and a stiff, formal manner of
relating to people. Charles described himself as depressed. In the first session, he told
this story:
G Following graduation with his BA degree, he had worked for a large multinational
company for four years.
G He was single, had never had a relationship with a woman, and had no friends.
G During the Masters programme, Charles had been in a series of constant battles
with tutors and the university administration about low grades and access to
part-time work he felt that the university was wanting to get rid of him.
G He felt frustrated, fatigued and demoralized, with poor concentration and
memory.
G Slept and ate well, and had no suicidal thoughts.
G Grew up in a normal middle-class family youngest of three children. Father
worked as a supervisor in a manufacturing plant; mother was a housewife.
G Beneath the surface, family life had been chaotic and violent parents continu-
ally fought with each other, and physically abused their children.
G Charles was the one who fought back, and as a result became a target of his fathers
rage.
G Father ignored the children as if they were pieces of furniture (did not say hello to
them if he passed them in the street), and played sadistic games that invited no-win
conflicts.
G Charles viewed his mother as weak and passive, and too frightened to get out of a
bad marriage.
G Parents divorced when he was at college.
G Charles did well at school this was valued by his mother and by teachers.
G In adolescence, perceived himself as awkward, unattractive and unathletic.
G Had chronic eye problems, had undergone several operations, beginning at
age 12.
G Had not been encouraged to talk about or work through any emotional reactions
he had to these frightening experiences.
G From the age of 13, Charles earned all his own money, as he never felt he could ask
his parents for anything, and paid his own way through college.
G Self-image was of himself as a fighter, a survivor, someone who could take care
of himself by himself entering therapy was seen as an admission of defeat,
shameful and a last resort.
140 The counsellors workbook

G Had been referred for therapy by the doctor who has been monitoring his eye
condition.
During the first session, Charles was concerned about confidentiality, and guarded
about revealing anything of himself, in case it might be used against him. He was tense,
cold and humourless. His difficulties were all the fault of someone else. The therapist
noted that she felt locked out of meaningful contact yet punished for my failure to
reach him, as he would always manage to let me know I was failing him in some way.
G What are the main issues that Charles is bringing to therapy?
G How would you describe the way that Charles relates to the world? What kind of a
world does he inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at
this time?
G If you were his therapist, what else would you be interested in knowing about
Charles in future sessions?
G How would you work with Charles? What would you be trying to do? What
techniques or strategies might you employ?
G What are Charless strengths?
G How many sessions do you think Charles would need? On what basis do you make
this estimate?
G What feelings are triggered in you by listening to Charless story? What might be
the significance of this emotional response?

Further reading
A detailed account of this case can be found in:
Skean, K.R. (2005) The case of CG: balancing supportive and insight-oriented psychodynamic
therapy with a client undergoing intense life stresses, Pragmatic Case Studies in Psychotherapy,
Volume 1, Module 3, Article 1, pp. 118, www.pcsp.libraries.rutgers.edu
141

The case of Ida

Ida is an intelligent and attractive young woman of 18 years of age. She has grown up in
a prosperous middle-class family with her father (a businessman), mother and brother.
Her father insists that she attend therapy, because of a range of symptoms that have
developed, and are severely limiting her life. These symptoms include: difficulty breath-
ing and speaking, sensation of choking, fainting spells, depression, avoidance of social
contact and threatening to commit suicide. At the first session, with some difficulty, Ida
describes her life in these terms:
G She is very close to her father, who is the dominant figure in the family.
G She is also close to her aunt (fathers sister), who has significant psychological
problems.
G Her mother rarely leaves the house, and is obsessed with order and cleanliness.
G Her brother is closer to his mother, and avoids his father.
Ida explains that her symptoms started to develop on a family holiday two years previ-
ously at the lakeside villa of Mr K, a long-time friend of the family the two families had
often gone on holiday together. Ida had been a babysitter for the children of Mr and
Mrs K, and was particularly fond of Mrs K. On this holiday, unknown to anyone else,
Mr K made a sexual advance to Ida, which she found very frightening. She told her
father about this, but he did not believe her, accusing her of making up what had
happened.
Ida described a dream that she had, which seems to her to refer to the sexual
incident:
the house was on fire. My father was standing beside my bed and woke
me up. I dressed quickly. Mother wanted to stop and save her jewel-case;
but Father said: I refuse to let myself and my two children be burnt for the
sake of your jewel-case. We hurried downstairs, and as soon as I was
outside I woke up.
G What are the main issues that Ida is bringing to therapy?
G If you were her therapist, what else would you be interested in knowing about Ida
in future sessions?
G How would you work with Ida? What would you be trying to do? What techniques
or strategies might you employ?
G What feelings are triggered in you by listening to Idas story? What might be the
significance of this emotional response?
142 The counsellors workbook

Further reading
The descriptive details provided above are taken from Freuds case of Dora (real name Ida Bauer).
This was one of the first cases to establish Freuds reputation. His own analysis of the case can be
found in:
Freud, S. (1977) Fragment of an analysis of a case of hysteria, in S. Freud (ed.) Case Histories,
Volume 1. Harmondsworth: Pelican Books.
As with many of Freuds cases, a great deal of additional material has been unearthed about
Ida/Dora, which provide the basis for a rage of different interpretations of what happened. Particu-
larly recommended are:
Bernheimer, C. and Kahane, C. (eds) (1986) In Doras Case. London: Virago.
Billig, M. (1997) Freud and Dora: repressing an oppressed identity, Theory, Culture and Society,
14: 2955.
Mahony, P.J. (1996) Freuds Dora: A Psychoanalytic, Historical, and Textual Study. New Haven,
CT: Yale University Press.
143

Anna: moving on in life

Anna had moved with her young son to a new city in a new part of the country to escape
from her former boyfriend, who had started to harass her after she had told him that their
relationship was at an end. He had spied on her by hacking into her computer, wire-
tapping her phone and breaking in to her apartment. During this period she feared for
her life, and felt that she was going crazy. She was now feeling depressed, desperate
and alone, and decided that therapy might help her. Her story was:
G Her best memories of her childhood were winning prizes at school for writing and
drama.
G Her parents had behaved in a physically and emotionally abusive way, which had
left her fearful about taking initiatives.
G In the early years of being a single parent, she had made money by working for an
escort agency at night; by day, she attended university and attained a nursing
degree.
G Her nursing licence had now lapsed, and she had no means of financial support
she relied on handouts from her parents.
G Her parents believed that she could not manage to bring up her son on her own.
G Her previous therapist had terminated treatment after one session, because she
regarded Anna as too seriously disturbed to work with in weekly therapy.
G Her doctor had suggested that she needed to see a psychiatrist, and receive
medication.
Anna told this story in an animated, expressive style, and made powerful contact with
her therapist.
G What are the main issues that Anna is bringing to therapy?
G How would you describe the way that Anna relates to the world? What kind of a
world does she inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at this
time?
G If you were her therapist, what else would you be interested in knowing about
Anna in future sessions?
G How would you work with Anna? What would you be trying to do? What tech-
niques or strategies might you employ?
G What are Annas strengths?
G How many sessions do you think Anna would need? On what basis do you make
this estimate?
G What feelings are triggered in you by listening to Annas story? What might be the
significance of this emotional response?
144 The counsellors workbook

Further reading
A detailed account of this case can be found in:
Duncan, B.L., Sparks, J.A. and Miller, S.D. (2006) Client, not theory, directed: integrating
approaches one client at a time, in G. Striker and J. Gold (eds) A Casebook of Psychotherapy
Integration. Washington, DC: American Psychological Association.
145

Case scenarios for working


with emotions

1 Whenever Pru felt criticized or hurt, she automatically went into a state of dis-
sociation, described as going out of my body, in which she could not speak, and
felt physically weak. It was impossible to work with either feelings or thoughts at
the core of her problems.
2 Janet was referred for therapy for her claustrophobia. Even after several sessions, it
was still very unclear what Janet actually experienced in relation to small spaces
she had avoided such experiences for so long that she had no recent episodes to
draw on.
3 Anna came from a strict religious background in which self-sufficiency and sto-
icism were encouraged. She was referred with chronic fatigue syndrome. It soon
became apparent that she kept constantly busy to keep difficult thoughts and
feelings at bay.
4 Sarah had received a diagnosis of borderline personality disorder. She felt
severely depressed and became increasingly out of control after her college tutor
said about a piece of her work thats interesting, but it isnt quite what I meant.
She was bombarded by a series of (familiar) thoughts I cant do anything right,
this is horrible, I cant control this and wished to burn herself. She said she
knew the feelings would stop if she did.
How would you approach each of these cases? Which theoretical ideas might you use
to gain a handle on the clients problems, in these scenarios? What further information
would you wish to collect from the client? What interventions might be suggested to the
client?
These case vignettes are adapted from:
Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M. and Westbrook, D. (eds)
(2004) Oxford Guide to Behavioural Experiments in Cognitive Therapy. New York: Oxford Uni-
versity Press.

These authors offer an authoritative account of how these cases might be approached from a
behaviouralcognitive perspective (see Chapter 17 and p. 411).
146

David: tackling self-blame

David was in his mid-50s when he entered therapy. He was married with one son, and
had a successful professional career. In the first session, he told his story:
G He had lost motivation and ambition in his career he felt that he had made the
wrong choice of career (influenced by his mothers expectations).
G Recently, he was becoming increasingly withdrawn from his wife.
G He was depressed since the age of 10.
G Entered therapy for the first time 10 years previously to deal with his depression.
G During a period of separation from his wife during a previous episode of therapy,
he had started to feel better; however, she begged him to return; he did so, and
became depressed again.
G Currently working from home; would prefer to have a job where he had more
direct contact with people.
G Anxious around people, particularly those in authority.
G Emotionally cut off from his siblings.
G Childhood family life characterized by fear, anger, loneliness and chaos.
G Experienced his mother as critical and withdrawn.
G Mother died when David was 13; his father then became an alcoholic,
leaving David to look after his younger siblings until he went to university at
age 18.
As he told this story, David was self-critical, blaming himself for everything that had
gone wrong in his life. In the session, he was able to express his feelings, as well as
reflect on them, and to make a good contact with the therapist. His goal for therapy was
to stop being depressed.
G What are the main issues that David is bringing to therapy?
G How would you describe the way that David relates to the world? What kind of a
world does he inhabit?
G Why now? What is the possible significance of choosing to visit a therapist at this
time?
G If you were his therapist, what else would you be interested in knowing about
David in future sessions?
G How would you work with David? What would you be trying to do? What
techniques or strategies might you employ?
G What are Davids strengths?
G How many sessions do you think David would need? On what basis do you make
this estimate?
Putting theory to use: thinking about cases 147

G What feelings are triggered in you by listening to Davids story? What might be the
significance of this emotional response?

Further reading
A detailed account of this case can be found in:
Watson, J.C., Goldman, R.N. and Greenberg, L.S. (2007) Case Studies in Emotion-focused Treat-
ment of Depression: A Comparison of Good and Poor Outcomes. Washington, DC: American
Psychological Association (Chapter 2).
Reflecting on
practice: challenges
and possibilities
within the therapeutic
relationship

Section contents
Introduction 151
Exploring moral values 152
The implications of your moral values for your approach as a counsellor 154
What is your personal philosophy? 155
Moral dilemmas presented by clients 157
Ethical decision-making 159
Deconstructing the meaning of confidentiality 161
Creating and maintaining a therapeutic relationship with a client 162
Expanding your relational responsiveness 163
Touching and being touched 165
Making sense of stories 167
Working therapeutically with metaphors 169
Responding to client interest in dreams 171
The meaning of boundary 172
What does counselling mean to people in your community? 173
Writing letters 174
The therapeutic use of reading 176
Using Internet resources to support therapy 178
Counselling in the media 179
Online counselling 180
Indoors or outdoors? Using nature in therapy 181
How to be really ineffective 183
Working with clients who are difficult or challenging 185

149
151

Introduction

The task of evolving a personal approach as a counsellor or psychotherapist is not


merely a matter of adopting a particular theoretical orientation, or assembling an
integration of different theoretical ideas. For many counsellors, the process of discover-
ing who they are as therapists only really hits them when they are faced with critical
issues in practice. The aim of this section of the Workbook is to present a series of
activities that evoke practical dilemmas that are associated with underlying questions
such as what kind of a counsellor do I want to be? and what is the personal style,
or way of being with others, which suits me best?
You may find that some of the scenarios and dilemmas described in these activities
are already familiar to you from your work as a therapist. In these cases, your response
to the learning task may help you to reflect more fully on your response to that situation,
or to begin to consider what your preferred response might be. Other scenarios and
activities may introduce situations that you may never have encountered in your actual
work with clients. In these cases, you may be able to use the learning task to imagine, or
rehearse, the ways in which you might approach such a situation when it does cross
your path.
The series of tasks in this section begin with a set of activities that invite you to
articulate and reflect on the moral choices and principles that you draw on in guiding
your work, and your life as a whole. The reason for beginning with moral issues
is that counselling is a highly morally sensitive endeavour. People who come to see a
counsellor are often struggling to make choices in their life to decide what is right
for them to do. The counsellor is inevitably drawn close to the persons life in a way
that makes it possible for him or her to hurt or exploit, as well as to help, the person.
If a counsellor does not have confidence in the moral stance that he or she is taking
in relation to the counselling relationship, it is likely that he or she may be paralysed,
unable to continue to be open to the clients process. It is therefore important, as
a counsellor, to be aware of ones own values and moral landscape. For most people,
this is a difficult thing to do; we live in a culture in which there are many competing
moral stances.
Other activities in the section reflect the huge diversity of counselling and psycho-
therapy methods that are currently in use. Becoming more aware of where you stand
in relation to these methods is a good way to explore your identity as a counsellor.
Inevitably, all counsellors find themselves drawn towards certain techniques, client
groups and modes of delivery, while avoiding others. Some of the learning tasks invite
you to look beyond your fascination or disinterest and to consider what having these
views means to you in terms of who you are or wish to be as a counsellor.
152

Exploring moral values

What are the moral values that are most important for you? Your practice as a counsellor
is inevitably embedded in your sense of what it means to be a good human being. The
issues and choices that some clients make will undoubtedly challenge that sense of
what is good or right. A personal approach to counselling is, therefore, informed by
an appreciation of your own moral positions, as well as a capacity to respect the moral
positions taken by others.
The three exercises described below are designed to enable you to begin to explore
your personal moral values.

Instructions
1 Sources of moral influence in your life

Take a piece of paper and draw a timeline from your birth to present. Along this line,
indicate the moral communities that you have belonged to at various stages in your
life. A moral community could be an organized religion, such as the Roman Catholic
Church or the communist party, or it could be a less formal network, such as the rugby
club, my friends or the feminism seminar group. A moral community is any grouping
that sets standards for its members about correct beliefs and the right way to do
things. For each of the moral communities, add a label listing the core moral rules or
values for which it stood. You may find that at particular points in your life you may have
been a member of more than one community. Once you have completed the timeline,
reflect on what you have learned, in relation to the consistent moral themes in your life,
and the areas of moral tension or uncertainty.

2 Moral proverbs and sayings

A good way to begin to map out your personal moral beliefs is to think about the moral
proverbs and sayings to which you make reference in everyday life. It is also of interest
to identify, if you can, the person who you heard saying these things to you in the first
instance. For example, you may have heard your grandmother saying, who does he
think he is?, or men are only interested in one thing. What do statements like these tell
you about your moral values and beliefs?

3 Your vision of the good life

What would your ideal world be like? What would Utopia be for you? Take a few
minutes to write about the characteristics of the good life from your own individual
perspective.
Reflecting on practice 153

Once you have completed these three exercises, bring together what you have learned
about your moral values by drawing a list of the values or virtues that are of central
importance in your life.

Further reading
To place your reflections in a broader context, you might wish to read the following book:
Tjeltveit, A. (1998) Ethics and Values in Psychotherapy. London: Routledge.
154

The implications of your


moral values for your
approach as a counsellor
The moral values and virtues that you espouse may help to shape the approach you take
as a counsellor or psychotherapist in a variety of ways. For each of the dimensions of
practice listed below, write some notes on the possible implications that might arise
from your moral position. For example, if aesthetic/artistic values are highly significant
for you, then this may imply developing a theoretical approach that makes space for
creativity, working in a setting that allows art therapy methods to be employed, and
so on. If socialist and egalitarian values are significant, there may be quite different
implications in terms of theoretical choice and work setting. You may find that your
individuality as a counsellor arises from the ways that you have found to balance or
reconcile different values in your own practice.

Theoretical orientation: different theoretical orientations tend to emphasize different


values, such as rationality, individual autonomy, spirituality, and so on. For you, what
are the links between your values and moral position, and the theories of counselling
that have meaning for you? It may be that certain theories allow you a vehicle to express
your values fully. Alternatively, there may be areas of tension: a theoretical model may
make a lot of sense to you in most respects, but there can nevertheless be specific ways
in which it is hard to align it with some of your moral beliefs.

Way of working as a therapist: there are many practical issues in therapy that reflect
value choices. Some of these issues include setting a limit to the number of sessions that
a client can receive, charging fees, seeing a client individually or in a family context.
Where do you stand on these matters?

Client groups: are there client groups that you are drawn towards, which you get
great satisfaction from? Are there groups of clients who are difficult for you to accept,
or whose values are hard for you to appreciate and understand?

Practice setting: in what ways do your values influence the types of counselling settings
within which you choose to work. For example, do you practise on a volunteer, unpaid
basis, or in a paid job, or both? In what ways might the values of your colleagues
matter to you? The values of organizational contexts may differ too, for example, some
counselling agencies are grounded in religious commitment, while others embrace
rational, evidence-based practice. How much do these factors matter to you?

Once you have reflected on these practice domains, and written some notes in response
to the questions outlined above, spend some time looking at the totality of your
response: what have you learned about your own values, and about the relationships
between these values and your counselling pracice?
155

What is your personal


philosophy?

Arthur Combs was an American psychologist who worked with Carl Rogers in the
1950s. His research looked mainly at one of the fundamental notions of early client-
centred therapy that effective counselling was essentially a matter of possessing
an appropriate attitude or philosophy of life, and conveying this to clients. For
Combs (1986: 5161; see also Combs, 1990), the key elements of the counsellors
attitude were:

Beliefs about significant data. Good helpers are people-oriented. They


seem to attend to internal personal meanings rather than external behav-
ioural data and tune in to how things seem from the point of view of those
with whom they work.

Beliefs about people. Effective helpers seem to hold more positive beliefs
about the people they work with than do less effective helpers. They see
them as trustworthy, able, dependable and worthy. Co-operative rather
than adversarial relationship attitudes: helper and client are on the same
side of the fence. Perceives others as having the capacity to deal with
their problems, and has faith that they can find adequate solutions, as
opposed to doubting the capacity of people to handle themselves and
their lives. Others are essentially dependable rather than undependable.
Confidence in the stability and reliability of others, and no need to be
suspicious of them.

Beliefs about self. A positive view of self, confidence in ones abilities, and
a feeling of oneness with others. Identifies with people, rather than sets
self apart from people tends to see self as a part of all mankind. Enough
rather than wanting self as having what is needed to deal with prob-
lems, rather than as lacking or unable to cope with problems. Willingness
to disclose or share things about self feelings and shortcomings are
important and significant rather than needing to be hidden or covered up.

Beliefs about purposes or priorities. Good helpers tend to see events in


terms of wider meanings and perspectives, from a broad rather than
narrow perspective. Concerned with the implications of events, rather
than merely with the immediate and specific. Not exclusively con-
cerned with details but can perceive beyond the immediate to future
and larger horizons.
156 The counsellors workbook

Learning task
Reflect on the following questions:
G To what extent do your basic beliefs or personal philosophy correspond with the
pattern that Combs views as associated with effective counselling?
G Do you believe that Combss model is necessarily correct? Some would argue that
he takes an over-optimistic and romantic view of the world, and that there are
other worldviews that can also be found in successful counsellors.
157

Moral dilemmas presented


by clients

To a large extent, developing a personal approach to counselling or psychotherapy


is a matter of learning from experience. Things happen in therapy that challenge
our beliefs and assumptions, and force us to reflect deeply on what it is that we
stand for.
The brief client vignettes on this page include situations that are not straightforward
for any counsellor or psychotherapist. How would you respond to these clients?
For each vignette, make some notes around the key practical and moral issues, as
you perceive them, and around the possible courses of action that you might pursue
in each case. What would you do?
Sam is a client referred by one of the GPs in the primary health clinic in which you
are employed as a counsellor as a member of the primary care mental health team.
The brief referral note that you have received states that Sam is undergoing a lot of
stress and needs help to deal with his anxiety. Sam comes in to your office and begins
by saying:
I need to get this off my chest. Its no good even starting to talk about
anything until I have made this clear. I need help because I am in court in
six weeks because I had sex with my partners eight-year-old daughter.
She threw me out of the house and called the police. I just feel awful. I
cant function at work at all. Everyone thinks I am just a piece of dirt. I
keep thinking about it all the time.
Eva and Dave are clients in a marriage/couple counselling agency in which you
work as a volunteer counsellor. They have already attended three sessions, and have
talked mainly about the arguments they have been having around whether they should
stay together. Both of them feel, for different reasons, that the sparkle has gone out of
their relationship. At the start of the fourth session, Eva begins to talk about the way that
Dave controls money. He sees himself as the breadwinner, and only gives Eva a fixed
amount of money each week to run the household. Eva does not have a bank account in
her own name, or any access to money without asking Dave. She turns to you and asks:
this isnt right, is it? How do you reply to Eva?
Gina is a university student, who has been using the counselling service off and on
throughout her course. She is in the second year of a degree. She has talked a lot about
how her parents have always been emotionally distant, and divorced when she was 12,
each of them starting new lives with different partners and starting new families. She
believes that other people do not like her, and complains that she has no real friends.
Now, she seems to have reached an impasse regarding her university work. Things have
not been going well, and she has fallen behind. She seems very depressed. In your most
recent session, she talked a bit about how she sometimes cuts herself. On the evening
following that session, she sends you an email in which she writes that she is feeling
worse than ever.
158 The counsellors workbook

What are the moral values that are evoked for you by each of these cases? What are
the moral principles that you might refer to when arriving at a solution or strategy in
response to the needs of these clients?
Which of these cases would be most and least difficult for you? Why?
159

Ethical decision-making

Chapter 17 of An Introduction to Counselling provides an outline of the ethical principles


that can be used as a guide for the practice of counselling. The websites of counselling
organizations such as the British Association for Counselling and Psychotherapy also
carry detailed codes of ethical practice.
Use this material, and any other sources available to you, to formulate your
decisions in relation to the following ethical dilemmas:
1 A client has been in counselling for a year, and has made great progress. She
brings in an expensive gift for you. She knows that this is something that you
would like, and she knows that you know that she would know this.
2 You have been counselling someone for six months who has a serious medical
condition. You have a similar medical problem yourself. At the start of counsel-
ling you decided not to mention your similar health problem to the client. How-
ever, now you are finding it extremely difficult to carry on with the counselling,
because what the client is talking about reminds you of your own pain, and you
keep wanting to cry during sessions.
3 You are a counsellor in a school. The rule is that any children under 16 need to
have parental permission to see you. You have just finished a group workshop for
a class of 15-year-old children on relationship skills. At the end one of them
comes up to you and launches into the story of her problems. When asked, she
says that her parents would never give her permission to see you officially.
4 You work in a therapy agency where you have a first assessment session with a
client, and then decide whether to offer him therapy or refer him elsewhere.
During the first assessment meeting with this client, you realize that: (a) his prob-
lem is within the remit of the service, (b) he is motivated to use therapy, and
(c) you find him physically threatening and intimidating.
5 You have been counselling a couple for some time. You all decide that it would be
useful to have a couple of individual sessions, where you see the husband and
wife separately. In the first individual session with the wife, she tells you that she
has been having an affair but that she does not want you to tell her husband.
6 You have been counselling a couple for some time, and it is clear that they have
serious relationship difficulties. At the time of the appointment only the wife turns
up. The phone rings. It is the husband. He tells you that he has moved his belong-
ings out of the house, and the marriage is over. He asks you to convey this
information to his wife.
7 For some time you have been struggling to find a publisher for a book you want to
write. It emerges that a client is a senior executive in a major publishing house.
Her professional advice would be invaluable to you. In passing, at the and of a
session, she mentions, if you ever need any help getting a book published. . . .
160 The counsellors workbook

8 After a long day seeing several clients, you use your partner as a sounding board
to talk through aspects of the work, but without disclosing details of the identity of
any of your clients.
9 With a client, you consistently feel a pull of sexual attraction.
10 At the end of a session, a client asks you for a hug.
11 At the end of a session, a client asks you to kiss him or her on the lips.
12 It is a late evening session, which has been a difficult and harrowing for the client.
She has no car, and has to walk through deserted inner-city streets.
13 A client you have worked with for a long time in private practice is terminally ill.
He asks if you would continue to see him in the hospice.
14 You are a counsellor in a rural area where everyone knows everyone else. How
do you deal with confidentiality?
15 You are a student counsellor in university. The counselling service is grossly
under-resourced, but you try to do the best you can. You feel strongly that people
in need should not be shunted on to a waiting list. You start to see clients during
lunch breaks, and stay late in the evening. One week, you add up that you have
seen 34 clients.
16 You work for a psychotherapy clinic that is highly sensitive to ethical issues. After
several stormy staff meetings, it is decided that to ensure informed consent, any-
one applying for therapy must be informed during their assessment interview of
all the alternative treatments that might exist for their problem, including drug
treatment, exercise regimes and meditation.

Questions for further reflection


G What have you learned about yourself, your values and your approach to therapy
from this exercise?
G What are the implications of these dilemmas, in terms of the supervision, support
and consultation that you require in order to work effectively as a counsellor or
psychotherapist?
161

Deconstructing the
meaning of confidentiality

The principle of confidentiality represents an essential aspect of therapy. It is clear that


counselling or psychotherapy is a conversation or meeting that takes place for the
person who is the client, rather than to compile any kind of report that might be handed
on to a third party. However, much of the time the significance of confidentiality is
largely taken for granted. Confidentiality is interpreted as being about making sure
that client records are kept safe, the fact that the client is attending a therapy clinic is
not made known to others, and so on. This activity invites you to develop a fuller
appreciation of the idea of confidentiality.
Over the space of a few days, carry out a personal inquiry into the meaning of
confidentiality. Some of the inquiry tasks that you might attempt are:
1 Look up the meanings of confidentiality contained in the Oxford English Diction-
ary. Pay attention to the origins of this term. What does the etymology of the word
tell you about some of the hidden, or implicit, meanings associated with the ways
in which the word confidential is used in both everyday and professional
conversations.
2 Imagine that you are going to see a counsellor for the first time. What are your
expectations or needs around confidentiality? What are your fears? Are there any
questions that you want to ask your counsellor concerning confidentiality? Do
you expect him or her to bring up the issue? What do you expect him or her to
say? What would happen if you came away from that first meeting with doubts
about the capacity of the counsellor to respect the confidentiality of information
about you?
3 Interview colleagues about their experience of confidentiality breaches. Have
they ever, when in the role of client or service user, known or suspected that their
confidentiality had been breached? How did they feel and what did they do?
Have they ever, in the role of practitioner, intentionally or unwittingly breached
the confidentiality of a client?
4 Consider the confidentiality guidelines from three professional codes of ethics,
reproduced on pages 5089 of An Introduction to Counselling. In the light of
what you have found in your inquiry, how adequate are these statements?
There may be many other inquiry strategies that you might pursue the ones listed
above are merely suggestions. Once you have reached a sense of closure in relation to
your inquiry, write a summary statement of your understanding of the meaning and
significance of confidentiality in counselling.
162

Creating and maintaining a


therapeutic relationship with
a client
The quality of the therapistclient relationship is considered within most schools of
practice to represent a key factor in therapeutic success. It is important for any therapist
to be aware of what he or she can do to promote a solid and reliable alliance with
clients.
The aim of this exercise is to give you an opportunity to reflect on what you do to
create a therapeutic relationship with a client. When reflecting on the questions below,
try to focus on the relationship dimension of your work with clients, rather than on the
therapeutic process.
Take a sheet of paper or page in your personal learning journal. Spend around
20 minutes writing about:
G What do I do in practice to create and maintain a relationship with my clients
(this can include verbal and non-verbal behaviours, actions, strategies, etc.)?
G What have I observed other therapists doing (e.g. in my own personal therapy, in
videos, in case studies) around relationship-building (both positive and negative)?
G What are the main cognitive resources (ideas, theories) that I use in making sense
of how I create and maintain a therapeutic relationship?

Reflection on this task


Take some further time to consider the following reflective prompts:
G What have I learned from this exercise about the way I work with clients, and the
theoretical basis of how I practise?
G What are my strengths and weaknesses around forming therapeutic relationships?
A study by Bedi et al. (2005) invited a sample of therapy clients to describe moments or
incidents in their therapy that they believed had been important in terms of developing
a relationship with their therapist. Compare the list of relationship-building strategies
that you use in your own work with the list of strategies that clients see as significant.
Does this suggest any gaps in your relationship repertoire?

Further reading
Bedi, R.P., Davis, M.D. and Williams, M. (2005) Critical incidents in the formation of the
therapeutic alliance from the clients perspective, Psychotherapy: Theory, Research, Practice,
Training, 41: 31123.
163

Expanding your relational


responsiveness

The quality of the clienttherapist relationship has emerged as possibly the single most
significant factor in effective therapy. In the absence of a relationship of trust, and a
capacity to work together, there is little hope that even the most well thought out
therapeutic activities will have much impact.
Different approaches to therapy are based on contrasting ideas about what might
be the best kind of relationship to offer clients. For example, the psychodynamic
approach advocates the establishment of a slightly distanced and highly consistent
relationship, which will function as a container for painful or shameful emotional
material. By contrast, cognitivebehavioural therapy (CBT) advocates a kind of athlete
coach, teacherpupil relationship, where the therapist seeks to help the clients to
acquire new skills.
Another way of looking at the therapeutic relationship is to take the view that
different clients need different kinds of relationship at different times, and that the most
effective therapists are those who have a broad enough relationship repertoire to adapt
to these needs.
What is you relationship repertoire? Howard et al. (1987) have identified four
relationship modes that can be helpful for clients at different stages in therapy:
1 High direction/low support: the therapist is in charge of what is happening. This
style is appropriate when the client is unwilling or unable to move him or herself
towards the goals of therapy.
2 High direction/high support: the therapist adopts a teaching/psycho-educational
role in relation to a client who has indicated a willingness to learn. This is the
relational style commonly found in CBT approaches.
3 Low direction/high support: the therapist using this style is essentially
accompanying a client who is engaged in a process of exploration and growth.
This is the relational style associated with person-centred counselling.
4 Low direction/low support: the therapist functions mainly as an observer of the
clients progress. This relational style is characteristic of classical psychoanalysis.

Questions for reflection


G Which of these relationship styles do you use most often in you work with clients?
G Which style do you use least often?
G Which is your preferred style, the one that you are most comfortable with? Is there
a relationship style that is impossible for you to exhibit?
G To what extent does this model help you to make sense of occasions when you
have felt that you were not being helpful to a client? On these occasions was the
164 The counsellors workbook

client looking for a way of relating from you that you were unable or unwilling
to fulfil?
G Identify one client with whom you have done good work. In what ways did your
relationship with this person change over the course of therapy in response to the
different learning needs of the client?

Further reading
Feltham, C. (ed.) (1999) Understanding the Counselling Relationship. London: Sage.
Howard, G.S., Nance, D.W. and Myers, P. (1987) Adaptive Counseling and Therapy: A Systematic
Approach to Selecting Effective Treatments. San Francisco, CA: Jossey-Bass. This book includes
a therapist relationship-style questionnaire.
Josselson, R. (1996) The Space Between Us: Exploring the Dimensions of Human Relationships.
Thousand Oaks, CA: Sage. This book offers a more comprehensive model of possible relation-
ship dimensions on therapy.
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University
Press (Chapter 14).
165

Touching and being


touched

The question of whether it is valuable, or acceptable, to touch clients (or be touched by


them) has been widely debated within the counselling and psychotherapy profession.
The position that a practitioner takes in relation to touch can be highly significant
in defining his or her personal approach. On the one hand, some therapists within the
humanistic tradition would argue that touch is a basic and fundamental form of human
contact and communication, and if clients are to come to their senses, touch will need
to be involved at some point. On the other hand, some psychoanalytic and psycho-
dynamic therapists would regard touching as deeply mistaken, reflecting a violation of
the boundary between client and therapist. Some classical analysts, sitting at the head
of a couch, situate themselves so that the patient cannot see them, never mind touch
them.
The following questions are designed to allow you to begin to map out your position
in relation to touch:
1 What are your own personal rules about touching and being touched? Under
what circumstances do you appreciate being physically in touch with another
person? What feelings do you associate with touch? What are the different mean-
ings associated with touch around different parts of your body, or the other per-
sons body?
2 It is possible to analyse counsellorclient touching into six categories. Touch can
be initiated either by the client or by the counsellor. Touch can take place at three
times:
G before the sessions (for instance, on the way to the counselling room shaking
hands on arrival);
G during the session (e.g. putting an arm round a client who is in distress);
G after the session (touching the clients shoulder on the way out of the room).
Which of these categories of touch do you engage in, or could imagine yourself
engaging in? To what extent does this depend on the client? Are there categories
of client who are for you touchable or out of touch?
3 What are the dilemmas that you have come across, or can imagine coming
across, in respect of clientcounsellor touch within your own practice?
Make some notes to record your reflections in response to these questions. Try to sum
up your conclusions in terms of your personal approach to touching in counselling. To
what extent, and in what ways, might your personal position be in accordance
with, or in conflict with, the rules for touching implicitly or explicitly adopted by the
theoretical model, workplace or training course within which you operate?
166 The counsellors workbook

Further reading
Hunter, M. and Struve, J. (1998) The Ethical Use of Touch in Psychotherapy. Thousand Oaks,
CA: Sage.
167

Making sense of stories

Sensitivity and awareness in relation to stories is a key skill in any kind of counselling or
psychotherapy practice. There are two kinds of story that clients tell, or refer to, in
counselling sessions:
G Stories about actual events or incidents that happened in the persons life. These
are concrete, specific accounts of what took place, who was involved and what the
person felt. Typically, clients tell five or six such stories during the course of a
therapy session.
G Stories about other people that have meaning for the client. These may often
be fictional stories, such as fairy tales, novels or films or religious stories. This
kind of story is mentioned less often in therapy sessions, but can be highly
significant.
In recent years, a substantial amount of research has been carried out into the signifi-
cance of the stories that clients tell in therapy. Some key principles have emerged from
these studies:
1 The story reflects the typical pattern of relationships in the persons life: the inter-
play of relationships within the stories that a person tells, or in which the person is
interested, can often reflect the pattern of relationships in that persons life as a
whole. For instance, does the person tell stories of being alone, being in two-
person relationships, being in three-person relationships, and so on? Lester
Luborsky has suggested that stories have an underlying structure in terms of how
the person expresses his or her needs in relation to others. He argues that any
story can be analysed in terms of the wish of the person, the response of the other
and the response of self. The types of wish, responses of other and responses of
self that a person expresses appear to be fairly consistent across all, or most, of the
stories that he or she tells.
2 The story conveys the persons image of the world that he or she lives in: what
kind of environment is described? Is the world that is evoked by the story a place
that is safe, where peoples needs are met, or is it a hostile and dangerous world?
3 The story expresses, or triggers in the listener, the emotions that are significant for
the teller: what are the feelings that are associated with different characters in the
story? How do you feel as a listener when hearing or reading the story?
In the Your favourite story exercise, in Section 1 of the Workbook, you were invited to
identify and summarize a favourite story from your own life. Apply the three principles
above to that story. In what ways does your favourite story encapsulate the key emo-
tional and relationship themes in your life? What have you learned about yourself from
reflecting on this story in these terms? In what ways might you envisage being able to
use these ideas in order to listen more fully to the meanings embedded in the stories that
your clients are telling you?
168 The counsellors workbook

If you chose a fairy story as your favourite story, you may be interested in consider-
ing the special significance of this kind of narrative. The psychoanalyst, Bruno
Bettelheim, and the founder of transactional analysis, Eric Berne, along with many
other therapists, have suggested that fairy tales embody basic human life-scripts.
Moreover, because fairy stories are heard by a child early in life, they have the potential
to act as a kind of template for the development of personality throughout a childs
later development.

Further reading
Ideas about different approaches to analysing clients narratives (including Luborskys model) can
be found in:
Angus, L.E. and McLeod, J. (eds) (2004) Handbook of Narrative and Psychotherapy: Practice,
Theory and Research. Thousand Oaks, CA: Sage.
McLeod, J. (1997) Narrative and Psychotherapy. London: Sage.
The significance of early childhood stories, such as fairy tales, is explored in two classic books:
Berne, E. (1975) What Do You Say After You Say Hello? The Psychology of Human Destiny.
London: Corgi.
Bettelheim, B. (1976) The Uses of Enchantment: The Meaning and Importance of Fairy Tales.
Harmondsworth: Penguin.
169

Working therapeutically
with metaphors

A great deal of what happens in counselling and psychotherapy relies on the use of
language the capacity of the client and therapist to communicate what they are
thinking and feeling, and use talk to negotiate different perspectives on problems.
Metaphors play a particularly crucial role within the language of therapy. Metaphors
can operate as a means of putting into words experiences that may be felt, but hard
to articulate. Metaphors also operate as shorthand reference points to complex patterns
of behaviour. However, working constructively with metaphors presents a major chal-
lenge for therapists: language is saturated with metaphor, and it can be difficult to stand
back from the ongoing flow of talk and be aware of the metaphoric expressions that
have arisen.
There are probably two main ways in which an awareness of metaphors can be used
by practitioners:
1 Listening for the metaphors that are generated by the client, and either exploring
these images and expressions in a spirit of collaborative inquiry (Rasmussen and
Angus, 1996; White, 2007) or using them as the starting point for a more struc-
tured exploration of meaning (Kopp and Craw, 1998).
2 Introducing healing metaphors into the conversation, which offer the client a
fresh and hope-inducing set of possibilities around reimagining their problem.
For example, in working with people who have experienced traumatic events that
have resulted in intrusive memories, Meichenbaum (1994: 3812) suggests that
there are a range of metaphors that can have healing potential, such as: not
addressing the traumatic memory is like building your house on top of a toxic
waste deposit, or talking about the painful memories in therapy is like setting a
broken bone or lancing a wound.

Learning task
Over a period of one or two weeks, use your personal learning journal to keep a record
of metaphors that arise in your work with clients, and in your everyday life. As you
document these observations, reflect on the following questions:
G How aware and sensitive am I to the occurrence of metaphors? What could I do to
become more sensitive?
G How effectively do I employ the opportunities afforded by metaphors to make
connection with the person with whom I am in conversation, or to explore the
potential meanings that are implied by metaphoric images and expressions?
G What are the most memorable metaphors that I have come across during this
period of documenting metaphors? What makes them memorable?
170 The counsellors workbook

G Are there metaphors that appear to have functioned in a negative fashion (e.g. by
locking the person into a destructive or self-limiting view of the world)?

Further reading
Kopp, R.R. and Craw, M.J. (1998) Metaphoric language, metaphoric cognition, and cognitive
therapy, Psychotherapy, 35: 30611.
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press.
Meichenbaum, D. (1994) Treating Post-traumatic Stress Disorder: A Handbook and Practical
Manual for Therapy. Chichester: Wiley.
Rasmussen, B. and Angus, L. (1996) Metaphor in psychodynamic psychotherapy with borderline
and non-borderline clients: a qualitative analysis, Psychotherapy, 33: 52130.
White, M. (2007) Maps of Narrative Practice. New York: W.W. Norton.
171

Responding to client
interest in dreams

Within modern societies, there are many people who are convinced that their dreams
offer them a valuable guide to finding answers to their difficulties in life. However,
relatively few therapists feel confident about their ability to work with client dreams.
In order to begin to be sensitive to the meaning-making potential of dreams, it is
necessary to have some experience of analysing ones own dreams. For a period of one
week, keep a record of what you dream each night. An effective way to facilitate the
recording of dreams is to keep a pen and notebook beside your bed, and write down
your dreams as soon as you awake. Before you go to sleep, gently ask yourself to dream,
and to remember what you dream. Over the period of a week, this procedure will
generate a number of examples of personal dreams. You may also find it helpful to write
down any memories you have of the most important dream you have ever had, or of
particularly powerful dreams you have experienced in the past.
When you explore your dreams, follow these steps:
G Are there any everyday events and experiences that seem to be reflected in your
dreams? If so, what does it mean that you have chosen to dream about these
particular events?
G Retell the dream out loud, as if it was happening, including any additional detail
that occurs to you as you are telling it. What are the thoughts and feelings that
occur to you as you are retelling the dream?
G What do you believe that the message of the dream is for you? Think of your dream
as a way in which you speak to yourself? What are you saying?
G Is there anything that the dream may be suggesting to you that you might do
differently in your life? How useful is this suggestion? How might you implement it
or follow it up? What might happen if you went along with what the dream wanted
you to do?
If you have found that this activity is helpful or interesting for you, then the next stage
may be to consider how you might incorporate these principles of dreamworking
into your practice with clients. There are many models of how to work with dreams
in therapy, and many training courses and workshops are available. Many therapists
have found that the ideas of Clara Hill provide a down-to-earth, practical means of
working with dreams, which can be integrated into most approaches to therapy.

Further reading
Hill, C.E. (1996) Working with Dreams in Psychotherapy. New York: Guilford Press.
Hill, C.E. (ed.) (2004) Dream Work in Therapy: Facilitation, Exploration, Insight and Action.
Washington, DC: American Psychological Association.
172

The meaning of boundary

The idea that relationships between people can be understood in terms of boundaries
has had wide application within the domain of counselling and psychotherapy. The
notion of boundary implies that there is a limit beyond which a person should
not go in their relationship with the other. Venturing beyond that limit is a violation
or transgression that may express something about the motivation of the violator.
There is much debate between therapists concerning the implications of the
use of the idea of boundary in counselling practice. It is important to keep in mind
that boundary is a metaphor, which like any metaphor highlights some aspects of
a phenomenon while concealing others.
This learning activity invites you to examine the meaning of the term boundary in
your own life through the following questions:
G What are the boundaries that you draw in your own everyday life? What are the
qualities or characteristics of these boundaries? How would anyone know that a
boundary existed for you? How would they know when they had transgressed
that boundary?
G A boundary can be defined as the edge of a territory or space where that
territory meets another territory. What other words or images do you use to refer to
this kind of phenomenon? (e.g. wall, barrier, fence, interface, line, and so on). How
does the use of these alternative terms change the meaning of this phenomenon?
G When you meet another person for the first time, what do you do to establish your
mutual boundaries?
G With someone you have known for some time, how do boundaries become
renegotiated or redefined?
G What kind of boundary do you seem to need in different situations? (boundaries
can be strong or weak, flexible or rigid, permeable or impermeable).
Once you have explored your personal experience of boundaries in your everyday life,
look at the implications of what you have learned for how you are (or how you would
wish to be) as a counsellor or psychotherapist:
G What are the different kinds of boundary that exist between you and your clients?
G How do you (and your clients) create and maintain these boundaries?

Further reading
The concept of boundary is discussed in:
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(pp. 41114).
173

What does counselling


mean to people in your
community?
In contemporary society, the theory and practice of counselling and psychotherapy
are characterized by diversity and multiple perspectives. Therapy is not a single, unitary
activity there are many different approaches and types of counselling and psycho-
therapy. To understand what therapy is, it is necessary to appreciate the contours and
implications of this diversity. This activity provides an opportunity to begin to map out
the various shades of meaning of the terms counselling and psychotherapy, both
in the community or city in which you live, and in the wider culture of which that
community is a part.

Tasks
G Where does counselling (defined broadly, to include both formal and informal
sources of therapy) take place in your community? Make a list of all the sources
of counselling that you can discover.
G What do the words counselling and psychotherapy mean to people? Ask
four or five people you know for their definitions of these terms. Talk to people in
different age groups.
G What do words like counselling, counseling, psychotherapy, coaching and self-
help produce from an Internet search?
G Over the course of a week, make a note of the prevalence of counselling and
psychotherapy stories and coverage, and the use of therapy jargon in the media
(newspapers, magazines, films, TV).
G Collect examples of jokes and cartoons about counselling and psychotherapy.
Once you have collected enough material on the social and cultural meanings of
counselling and psychotherapy, use it as a basis for reflecting on the following issues:
G What has your research taught you about the state of therapy today?
G What do people know about counselling and psychotherapy? What are their
fantasies?
G What are the key themes in peoples views of counselling and psychotherapy?
G How positive is the public perception of therapy? What are the areas of public
misunderstanding of counselling and therapy that you have come across?
G What might be the possible sources of this confusion?
G What is your impression about what could be changed to make counselling and
psychotherapy more relevant or accessible to people?
G How do these public images of therapy have an impact on your work as a
counsellor?
174

Writing letters

A constant issue in counselling is the persons relationship with significant others in


his or her life. From a narrative perspective, people can often become stuck in their
lives by repeating the same old story over and over again to other people close
to them.
One useful way of helping people to review and, if necessary, change these stories is
to invite them to write a letter to this other person. Typically, these letters are never sent,
or maybe the final one from a series of letters is sent, with the earlier letters (angry,
confused, despairing) being retained in a diary or destroyed.
Clients may be invited to write a letter during a counselling session, but more usually
write in their own time and bring the letter in the next time they see their therapist.
Letter writing is often used by bereavement counsellors; for example, writing to someone
who has died.
The aim of this learning activity is to give you an opportunity to explore the
experience of therapeutic letter-writing.

Instructions
Think of someone in your life who is, or has been, important to you, but with whom
there are currently some unresolved issues. This could be someone you have fallen out
with, someone who has moved away to live in another place, or someone who has died.
Give yourself at least 45 minutes to write a letter to this person. Do not censor what you
write this letter will never be sent. Keep writing down everything that you might
possibly wish to say to this person positive as well as negative. Once you have finished
writing the letter, put it in a safe place.
One or two days after your letter-writing episode, take some time to consider the
following questions:
G How did you feel when you were writing the letter? What was the experience
like for you?
G Have your thoughts, feelings and attitude towards the letter recipient changed?
In what ways?
G Do you now wish to read the letter again? What do you want to do with it? Is
there anyone you would like to ask to read the letter?
G Has the writing of this letter been helpful or beneficial for you, or unhelpful and
destructive? Or both?
G What are the therapeutic processes that took place?
Reflecting on practice 175

Finally:
G What have you learned about the relevance of therapeutic letter-writing for your
own approach to counselling?
G What further training, research or supervision might you need in order to become
competent in this way of working with clients?
176

The therapeutic use


of reading

One of the techniques that has always been used by people to sort out their problems
is to get insight and advice through reading. Although some counsellors and psycho-
therapists have always recommended books to their clients, it is only recently that
this practice has received much attention in terms of theory and research. This learning
activity invites you to think about the extent to which therapeutic reading (self-help
books or bibliotherapy) might form part of your personal approach as a counsellor.
Visit a public library and examine the section with self-help books. Most of these
will be for medical conditions, but some will concentrate on psychological problems
such as assertiveness, depression, and so on. Look through these books to get a sense
of what they have to offer, and then choose one book to read, preferably on a topic that
has some personal meaning for you.
When reading the self-help book, consider these questions:
G How helpful do you think this book would be? Would you recommend it to
a client?
G Who would find it useful?
G What makes it helpful or unhelpful?
G What model or models of therapy is the book promoting? For example, is it
essentially offering common-sense advice, psychodynamic insights, or some other
approach?
G Are there any ways in which, in your opinion, the book might be dangerous or
misleading?
G How culturally inclusive is the book?
G What are the advantages and disadvantages of using this book when compared to
face-to-face counselling?
You might also find it interesting to do an Internet search on self-help, or follow up
the reviews and discussion of recently published self-help books on the Amazon book-
shop website (you can even send in your thoughts on the book you have read as a
contribution to Amazon).

Final questions
G What are the characteristics of good self-help books in your view? Are stories of
how others had overcome similar problems most helpful, or is it better to provide
structured learning routines? How important is it for self-help materials to have a
spiritual dimension?
G What are the practical implications of integrating the use of self-help reading
materials into your counselling practice; for example, at what point might you
Reflecting on practice 177

recommend a book? How might you link the book into what happens in face-to-
face sessions?
G How useful might movies be as an alternative to self-help books? Which films
could you imagine using? People typically become more emotionally involved in
movies is this helpful or not?

Further reading
Campbell, L.F. and Smith, T.P. (2003) Integrating self-help books into psychotherapy, Journal of
Clinical Psychology, 59: 17786.
Norcross, J.C. (2006) Integrating self-help into psychotherapy: 16 practical suggestions, Profes-
sional Psychology: Research and Practice, 37: 68393.
178

Using Internet resources


to support therapy

An increasing proportion of the public turn to the Internet for information and advice on
relationship issues and mental health problems. The Internet represents a potentially
invaluable resource for counselling and psychotherapy as a means of augmenting and
supporting the work done within conventional face-to-face therapy.
How aware are you of websites that might be of value for your clients? How often do
you ask clients about their use of websites as a means of managing their problems? How
do you respond when a client reports that he or she has made use of online sources?
Identify a problem area that occurs on a regular basis in your client group (e.g.
depression, eating disorders, social phobia/loneliness, relationship problems, low
self-esteem, etc.), and spend some time searching the Internet for sites on that topic.
When examining these sites, consider the following questions:
G How helpful do you think various sites would be for your clients? Which ones
would you recommend to clients?
G What are the features of the sites you have explored that makes them more or less
helpful or unhelpful?
G Are there any ways in which, in your opinion, the book might be dangerous or
misleading?
G How culturally inclusive are the sites you have visited?
G What are the issues involved in integrating the use of Internet sites into your
therapy practice?

Further reading
Grohol, J.M. (2004) The Insiders Guide to Mental Health Resources Online, revised edition. New
York: Guilford Press.
Zuckerman, E. (2003) Finding, evaluating, and incorporating internet self-help resources into
psychotherapy practice, Journal of Clinical Psychology, 59: 21725.
179

Counselling in the media

Magazine problem pages (agony aunts) and TV shows such as Oprah Winfrey
probably represent the most widely used forms of counselling in Western societies.
However, are these outlets providing experiences that are genuinely therapeutic, or are
they merely forms of entertainment?

Learning tasks
G Analyse what you find in the problem pages of at least two contrasting publications
(e.g. one from a serious newspaper and one from a popular womens magazine).
What kind of advice do they give? What types of problem are addressed? What are
the therapeutic processes that could be taking place?
G Analyse, in a similar fashion, some TV shows in which personal problems are
explored.
Once you have collected some material on media counselling, consider the following
questions:
G How helpful do you think these outlets might be for those who use them? Would
you recommend them, or use them yourself?
G Who seems to make use of these forms of help? Are they the same people who
make use of counselling?
G What are the helpful and unhelpful aspects of media therapy
G What model or models of therapy are being promoted? For example, are they
essentially offering behaviourist advice, or psychodynamic insights, or some other
approach?
G What are the advantages and disadvantages when compared to face-to-face
counselling?
G Are there any ways in which they might be dangerous or misleading?
G If asked, would you host a TV show of this kind, or edit a problem page? If not,
why not?
G How should professional counselling and psychotherapy associations respond to
the growth of media therapy?
180

Online counselling

One of the basic assumptions or cherished truths held by the vast majority of counsel-
lors and psychotherapists is that the quality of the therapeutic relationship is crucial
to success in therapy. But what happens when client and counsellor never meet
each other?
Most therapists believe that counselling at a distance (e.g. using telephone, letter or
email) may be necessary in emergencies (e.g. crisis helplines such as the Samaritans)
but can never achieve the depth and meaningfulness of conventional face-to-face
therapy. However, in recent years email has increasingly been used as a medium for
therapy.
Reflect on your own experience with email:
G Do you ever use it for therapeutic purposes (e.g. with friends)? How effective
is this for you? For you personally, what are the advantages and disadvantages of
email when compared to talking to someone face-to-face?
Spend some time searching the Internet for online counselling services:
G How helpful and trustworthy do these services appear to you?
G How do you imagine you might feel, as a potential client, using such a service
for the first time what might your hopes and fears be?
G What are the challenges that you might imagine as an online counsellor? What
new or different skills might you require?
Finally, in terms of the online counselling that you have examined, what do you believe
could be the opportunities and also the limitations of email therapy?

Further reading
Goss, S. and Anthony, K. (eds) (2003) Technology in Counselling and Psychotherapy: A Practi-
tioners Guide. London: Palgrave Macmillan.
Lange, A., Schoutrop, M., Schrieken, B. and Ven, J.-P. (2002). Interapy: a model for therapeutic
writing through the internet, in S.J. Lepore and J.M. Smyth (eds) The Writing Cure: How
Expressive Writing Promotes Health and Emotional Well Being. Washington, DC: American
Psychological Association.
181

Indoors or outdoors? Using


nature in therapy

Traditionally, influenced by the example of the doctorpatient consultation, counsel-


ling and psychotherapy sessions have taken place in offices. The content of therapy
sessions has generally focused on either interpersonal problems that have been troub-
ling the client, or difficulties the person has been having in regulating their thoughts and
feelings.
In recent years, some practitioners have started to challenge these assumptions, in
arguing that the relationship of a person with nature represents a crucial dimension of
well-being, and that finding ways of bringing nature into the therapeutic process can be
highly beneficial.
One approach to the use of nature is to hold therapy sessions out of doors, for
example, in a wilderness area. Another approach is to invite the client to consider their
relationship with nature, and to examine the link between that relationship and the
problems they are experiencing in their life. Burns (1998) has devised a simple tech-
nique for facilitating this process, which he has called the sensory awareness inventory.
The client is given a piece of paper divided into six labelled columns: sight, sound,
smell, taste, touch and activity. They are then instructed: under each heading, please
list 1020 items or activities from which you get pleasure, enjoyment or comfort.
What the client has written can be used in therapy in different ways. The client can
be asked simply to consider what he or she has learned about him or herself from
completing the exercise. Typically, clients report that there are many sources of sensory
pleasure, enjoyment and comfort that they have been neglecting in their life, and which
would be valuable to restore or expand. Following further exploration, connections
may often be made between personal problems and the absence of nature-based
experience.
How relevant is working in and with nature for your practice, and your personal
approach as a counsellor? What are the advantages and disadvantages that you imagine
might be associated with seeing clients out of doors?
Try the sensory awareness inventory for yourself. What did you discover about your-
self? Could these discoveries be of potential value in your therapy?
If you find, arising from these reflections, that nature-influenced work is attractive
and meaningful for you, then also consider: what are the theoretical implications of
working in this way?
182 The counsellors workbook

Further reading
Burns, G.A. (1998) Nature-guided Therapy: Brief Intervention Strategies for Health and Well-being.
London: Taylor & Francis.
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(pp. 34952).
183

How to be really ineffective

Research studies into the outcomes of therapy have found that a substantial number of
people with psychological problems get better without making use of professional help,
and that there is a wide range of levels of effectiveness across therapists. Some counsel-
lors and psychotherapists appear to get good results with almost every client they see,
while other practitioners may only generate a good outcome with around 30 per cent of
their clients.
These issues were recognized as early as 1969 by the family therapist Jay Haley
(1969, 6915):
What has been lacking in the field of therapy is a theory of failure.
Many clinicians have assumed that any psychotherapist could fail if he
wished. However, recent studies of the outcome of therapy indicate
that spontaneous improvement of patients is far more extensive than
was previously realized. There is a consistent finding that between fifty
and seventy percent of patients on waiting list control groups not only
do not wish treatment after the waiting list period but have really
recovered from their emotional problems . . . Assuming that these find-
ings hold up in further studies, a therapist who is incompetent and
does no more than sit in silence and scratch himself will have at least a
fifty percent success rate with his patients. How then can a therapist
be a failure?
In an attempt to develop a comprehensive theory of therapeutic failure, Haley (1969,
6915) identified 12 key factors. There is not space to summarize all the Haley model
here. However, the first factor conveys the gist of his analysis:
The central pathway to failure is based upon a nucleus of ideas which, if
used in combination, make success as a failure almost inevitable:
Step A: Insist that the problem which brings the patient into therapy is not
important. Dismiss it as merely a symptom and shift the conversation
elsewhere . . .
Step B: Refuse to treat the presenting problem directly. Offer some
rationale, such as the idea that symptoms have roots, to avoid treating
the problem . . .
Step C: Insist that if a presenting problem is relieved, something worse
will develop. This myth makes it proper not to know what to do about
symptoms and will even encourage patients to cooperate by developing
a fear of recovery.
How far do you agree with Haleys analysis of the process of therapeutic failure? Do you
agree with him that an understanding of failure is an essential element of any approach
184 The counsellors workbook

to counselling? What is your own theory of failure in terms of your own work as a
counsellor? How do you explain failure?

Further reading
Haley, J. (1969) The art of being a failure as a psychotherapist, American Journal of Orthopsychiatry,
39: 6915.
185

Working with clients who


are difficult or challenging

For any counsellor or psychotherapist, the majority of clients that he or she works with
are people who are likeable, constructive and open to learning. However, there are
some clients who are hard to reach, and other clients who may be experienced
as threatening or intrusive. One of the key hurdles for any practitioner is to develop
strategies for responding effectively and professionally to the needs of clients who may
be difficult or challenging.
Use the questions below to explore your perceptions of one difficult or challenging
client or situation that you might come across as a counsellor or psychotherapist. This
can be a client who you have already met, or someone that you fear that you may come
across in the future.
1 What would the situation be (e.g. agency setting, first session or later session, etc.)?
2 What are the characteristics of the client; for example, age, gender, social class,
ethnicity, physical appearance, and so on?
3 What is this clients presenting problem?
4 What lies behind the problem?
5 What does the client do that is most hard for you to handle? (e.g. gets angry, acts
seductively, challenges and questions you, hears voices, talks about being an
abuser, demands that you give advice, etc.).
Take some time to write about this client, the emotions and reactions that he or she
triggers in you, and your strategies for responding to him or her.
Once you have described this scenario, take some further time to write about what
you have learned about:
G how you either undermine or support yourself in tough situations, through your
self-talk/internal dialogue;
G how you deal with emotions that are strong and not under control;
G your strategies for dealing with therapy crises: what skills or concepts/theories do
you fall back on when under most pressure;
G your willingness to be honest with colleagues or your supervisor about how scary a
client has been for you;
G your resilience and resourcefulness as a therapist;
G your career choices what clients or counselling settings are best/worst for you to
work with?
G your future training needs in relation to how to handle difficult situations.
186 The counsellors workbook

Further reading
You may find it helpful to place your own experience of difficult client situations in a broader
context by reading about the experiences of other therapists in relation to this issue:
Kottler, J. and Carlson, J. (2003) Bad Therapy: Master Therapists Share Their Worst Failures.
London: Brunner-Routledge.
Kottler, J. and Carlson, J. (2005) The Client who Changed Me: Stories of Therapist Personal
Transformation. London: Routledge.
Schroder, T. and Davis, J. (2004) Therapists experiences of difficulty in practice. Psychotherapy
Research, 14: 32845.
Theriault, A. and Gazzola, N. (2006) What are the sources of feelings of incompetence in
experienced therapists? Counselling Psychology Quarterly, 19: 31330.
Developing a
professional identity:
putting it all together

Section contents
Introduction 189
Reviewing your skills and qualities as therapist 190
Images of therapy 191
What are you aiming to achieve as a therapist?: selecting criteria
for evaluating your effectiveness 192
Whats in your toolbox? 194
Marketing yourself as a counsellor: your one-minute intro 196
Are you a counsellor or psychotherapist? 197
Your therapy room 199
Building an effective support network 200
Your position in relation to research and inquiry 202
What does it mean to be personal?: some questions from Carl Rogers 203
Ten years from now 204
Critical issues for counselling and psychotherapy 205

187
189

Introduction

The aim of this section of the Workbook is to provide some opportunities for reflecting
on the questions and activities in earlier sections in order to arrive at an understanding
and appreciation of your sense of identity as a counsellor or psychotherapist. There are
perhaps two main dimensions to this process: summing up, and looking ahead.
The exercises in the Workbook have involved exploring many different aspects of
what is involved in being a therapist. Learning about therapy is an open-ended com-
mitment: there is always more to be known, new edges of awareness, surprises.
But it is also likely that you may have used the Workbook at a stage in your career
when learning and development have been a primary focus, and are set to move into
another stage in which application and practice are more central. It can be useful, at this
point of transition, to take stock of what you have learned in the sense of being clear
about your achievements and resources. Moreover, by documenting these achieve-
ments and resources (e.g. by writing and keeping your reflections on the tasks in this
section) you are creating a statement about where you are now to which you may wish
to return at some point in the future. Summing up and taking stock can also contribute
to a sense of closure at the end of training. Many training programmes and courses
require students to assemble a self-evaluation statement at the end of the course, which
is then reviewed by tutors and fellow course members. The exercises in this section
of the Workbook are no substitute for such an assignment, but may still be useful in
stimulating self-reflection around relevant themes.
This final section also looks ahead at the future possibilities and next steps in your
journey as a therapist, in relation to the type of work you might do, and the further
training and personal development that might be helpful. Becoming a counsellor or
psychotherapist is about more than learning theory and skills, and acquiring practical
experience. It is about evolving a professional identity, a sense of who you are in your
work. Hopefully, by the time you have completed this Workbook, the outline of that
professional identity, and its basis in who you are as a person, should be at least
beginning to be more consistently visible.
190

Reviewing your skills and


qualities as a therapist

The aim of this exercise is to give you an opportunity to draw some conclusions from the
exercises you have completed in the Workbook. Reflect on the various learning tasks
with which you have engaged in the Workbook, and also on other sources of learning
concerning yourself as a counsellor or psychotherapist (for instance, courses you have
attended, work with clients).
Taking all this as a whole, how can you sum up your qualities as a therapist?
Spend some time writing in response to these instructions:
1 Make a list of your gifts, glittering qualities and strengths as a therapist.
2 Make a list of areas that might sometimes be personal limitations, gaps or blind
spots in your capacity to offer a therapeutic relationship.
3 Tell the story of at least one of the gifts in a bit more detail: (i) what it was in your
life that allowed you to develop this gift, and (ii) the effect this quality has on
people you are helping.
4 Explore one of your limitations in a similar fashion: (i) what it was in your life that
contributed to this limitation in your capacity to help, and (ii) the effect this
limitation might have on the people you are helping.
What are the implications for you as a therapist of what you have written in response to
these questions? What do your responses say about who you are, and what you stand
for as a therapist?
Chapter 20 of An Introduction to Counselling offers a model for understanding
counsellor development in terms of seven dimensions of competence. How do the gifts
and limitations you have identified fit into this model? Does the model suggest other
gifts and limitations that you had not considered?
Looking ahead: when you reflect on what you have learned from this exercise, what
are the implications for:
G the type of work you do as a therapist (e.g. long- or short-term therapy with clients,
specific client groups, etc.);
G your future learning needs; for instance, through training, supervision or personal
study;
G your role within the profession (as a supervisor, trainer, professional activist, writer,
researcher).
191

Images of therapy

One of the key skills possessed by effective therapists is sensitivity to language, to the
ways in which people construct their emotional and interpersonal worlds through the
words, images and metaphors that they use. An awareness of your own language use
can also provide you with a creative means of exploring your own personal assump-
tions about therapy. In this activity, you are invited to find images and metaphors that
capture the overall sense of what counselling and psychotherapy means to you.
This task involves taking a few moments to reflect on the images and metaphors that
come to mind when you think about different aspects of the therapy process.
Write whatever comes into your mind when you read the following questions:
G What kind of animal is a counsellor or psychotherapist? A client?
G What kind of a sport is counselling or psychotherapy?
G What kind of imagery comes to mind when you think about the process of counsel-
ling or psychotherapy:
The interaction between a therapist and client is similar to. . . .?
A good counsellor or psychotherapist is like a. . . .?
Completing a series of counselling sessions is like. . . .?
Many different types of image and metaphor may arise for you write them all down.
If possible, categorize these images and metaphors into themes.
Look at each of the metaphors you have generated. What aspects of therapy are
highlighted by each metaphor, and which aspects are downplayed?
Once you have thought of the images and metaphors that strike a chord for
you, you might wish to think about how they compare with the metaphors that
underpin mainstream theories such as person-centred, psychodynamic and cognitive
behavioural.
What have you learned from this task about your own deeply held attitudes and
assumptions? What have you learned about your position in relation to mainstream
theories?
The psychotherapy researcher, Lisa Navajits, asked a number of counsellors and
therapists to write down their images for the therapy process. What she found is
described in McLeod (2009: 428). Do her results include metaphors that surprise you,
or which you disagree with? If so, what might this mean in relation to your personal
approach as a counsellor or psychotherapist?

Further reading
A fascinating book on the role of metaphor in human thought, which explains the highlighting/
downplaying notion, is:
Lakoff, G. and Johnson, M. (1980) Metaphors We Live By. Chicago, IL: University of Chicago
Press.
192

What are you aiming to


achieve as a therapist?:
selecting criteria for
evaluating your effectiveness
One way of summing up your approach to counselling or psychotherapy is to be clear
about what it is you believe that therapy is trying to achieve. What are the desired
outcomes of therapy? There are many competing ideas about the appropriate criteria for
assessing the effectiveness of counselling and psychotherapy. Many research studies,
and counselling organizations, use questionnaires that measure client change in
terms of psychiatric categories such as depression and anxiety. Some practitioners
view outcomes in terms of factors that are consistent with their theoretical approach.
For example, person-centred counsellors look for change in self-esteem and self-
acceptance, while cognitivebehavioural therapists seek change in observable
behaviour and dysfunctional beliefs.
The CORE system is increasingly being used as an evaluation tool that provides an
integrative focus, not rooted in any particular therapeutic model or ideology. The CORE
questionnaire assesses client outcomes on four dimensions: subjective well-being, psy-
chological symptoms, social and interpersonal functioning, and risk to self and others.
The CORE system is discussed in McLeod (2009: 5912).
The Just Therapy centre in New Zealand, led by Charles Waldegrave, Kiwi Tamasese,
Flora Tuhaka and Warihi Campbell, has developed an approach to therapy that draws
on the traditions of the three main communities in their country: Maori, Samoan and
Pakeha (European). They identify their criteria for effective work in the following way:
. . . we have chosen three primary concepts that characterise our Just
Therapy approach. When assessing the quality of our work, we measure
it against the interrelationship of these three concepts. The first is belong-
ing, which refers to the essence of identity, to who we are, our cultured
and gendered histories, and our ancestry. The second is sacredness,
which refers to the deepest respect for humanity, its qualities, and the
environment. The third is liberation, which refers to freedom, wholeness
and justice. We are interested in the inter-dependence of these concepts,
not one without another. Not all stories of belonging are liberating, for
example, and some experiences of liberation are not sacred. We are
interested in the harmony between all three concepts as an expression of
Just Therapy.
(Waldegrave, 2003: 75)

Take a few moments to reflect on the outcome/effectiveness criteria that you use in your
work as a counsellor or psychotherapist. It may be helpful to think about clients who you
might consider to be good outcome cases, and some who you felt had poor out-
comes. What are the factors that made these cases seem good or not so good?
Developing a professional identity 193

Make a list of the outcome criteria that are important for you.
What does this list say about who you are as a counsellor or psychotherapist, and
what you stand for?
194

Whats in your toolbox?

Counsellors can be divided into those who have toolboxes and those who do not. A
toolbox is a personal store of ideas, exercises, stories and strategies that the counsellor
can draw on to facilitate the therapeutic process, or to move things on when the therapy
seems to have reached an impasse.
An example of a counsellors toolbox can be found in a brilliant book by Susan
Carrell, who describes more than 40 tools that she has acquired in over 20 years of
practice. Some of these tools are tangible and take up space; for example, a sand tray
for adults. Others require only paper and pens; for instance, a Life-Line (timeline)
exercise. Still others are virtual tools, stored in the counsellors head. For instance:
when your female client is agonizing over what to do about a difficult
situation her boyfriend is treating her poorly, a co-worker humiliated
her, she suspects her husband is cheating her . . . and she looks at you
pleadingly seeking advice, ask her this question: What would you say to
a girlfriend who came to you with this story?. . . . This question elicits
responses that come from a deep place in a womans psyche. It appeals
to the sanctity of friendship between women and the long history of
devotion that women friends have enjoyed . . . Women know that boy-
friends come and go, husbands come and go, children come and go, but
girlfriends are forever. She will give her girlfriend (and thus, herself) the
best advice ever.
(Carrell, 2001: 184)
Some therapists might argue that such tools are inevitably superficial, and are no substi-
tute, in the end, for the rigorous application of basic therapeutic principles derived from
a solid theory. But is this necessarily true? Maybe therapists who are grounded in a
specific theory (unlike Susan Carrell, who could perhaps be described as a pragmatic
eclectic) merely carry a kit of tools that are selected on the basis of theoretical consist-
ency (as well as effectiveness).
Irvin Yalom is a leading figure in existential psychotherapy perhaps one of the least
toolbox-oriented therapies that could be imagined. Yet he has published what he has
described as a nuts-and-bolts collection of favourite interventions (Yalom, 2002: xiv).
These include guidelines for challenging clients (strike while the iron is cold), strat-
egies for checking into the here-and-now each hour, suggestions for making home visits
and interviewing the clients significant other, and much else.

Instructions
Take a few minutes to list the items in your own therapeutic toolbox. Are there tools that
you have once used, and have now discarded, or rarely employ? Are there tools that you
Developing a professional identity 195

would wish to include in your kitbox, or that you have acquired and are uncertain
about using?
What do these tools signify about your identity as a counsellor?

Further reading
Glimpses into the toolkits of some well-known therapists can be found in:
Carrell, S. (2001) The Therapists Toolbox: 26 Tools and an Assortment of Implements for the Busy
Therapist. Thousand Oaks, CA: Sage.
Mahoney, M.J. (2003) Constructive Psychotherapy: A Practical Guide. New York: Guilford Press.
Seiser, L. and Wastell, C. (2002) Interventions and Techniques. Buckingham: Open University
Press.
Yalom, I. (2002) The Gift of Therapy: Reflections on Being a Therapist. London: Piatkus.
196

Marketing yourself as
a counsellor: your
one-minute intro
Developing a coherent and integrated sense of who you are as a counsellor is not
merely a personal development task. There are many situations where you may be
called upon to explain or describe your approach to different audiences. This exercise
invites you to write your response to the following scenarios:
1 The one-minute intro: you are in a group situation where you have been given
one minute to introduce yourself and your counselling approach. Perhaps you
have been invited to discuss your work with some trainees on a counselling
course, or you are being interviewed for a job as a counsellor, or you are joining a
peer support group. What do you say about yourself?
2 A leaflet: you have been appointed as a counsellor in a health clinic, student
counselling service or some other setting. In order to help potential clients to
access your service, you need to design a leaflet that describes your counselling
approach and explains what is involved in being a client. What do you write?
3 A website: as a means of promoting your private practice work, you decide to
develop your own website. How do you describe yourself within this medium?
4 An activity: imagine that you have been asked to facilitate a two-hour workshop
with a group of students of nursing or social work, with the aim of helping them to
learn about what your approach to counselling is about, at an experiential level.
Is there one exercise or activity that might allow these students to go beyond a
purely intellectual understanding of your approach?
After you have completed these tasks, you may find it interesting to carry out a survey of
leaflets and websites composed by other practitioners. Reflect on the different ways in
which other colleagues have approached the task of depicting their approach. What
does the approach you have adopted say about who you are as a counsellor?

Further reading
Two writers who have explored their own struggle to characterize their approach for external
audiences are:
Morgan, A. (1999) Practice notes: introducing narrative ways of working, in D. Denborough and
C. White (eds) Extending Narrative Therapy: A Collection of Narrative-based Papers. Adelaide:
Dulwich Centre Publications.
Sween, E. (1999) The one-minute question: what is narrative therapy?, in D. Denborough and
C. White (eds) Extending Narrative Therapy: A Collection of Narrative-based Papers. Adelaide:
Dulwich Centre Publications.
197

Are you a counsellor or


psychotherapist?

How do you identify yourself in professional terms? In the table below, counselling and
psychotherapy are depicted as activities that are equally valuable, with many areas of
overlap, but also representing distinctive traditions of helping.

Psychotherapy Counselling
Similarities
Provides the person with a confidential space in Provides the person with a confidential space in
which to explore personal difficulties which to explore personal difficulties
Effective practice depends to a great extent on the Effective practice depends to a great extent on
quality of the clientpsychotherapist relationship the quality of the clientcounsellor relationship
Self-awareness and personal psychotherapy are Self-awareness and personal therapy are valued
valued elements of training and ongoing elements of training and ongoing development
development
Differences
A wholly professionalized occupation An activity that includes specialist professional
workers, but also encompasses
paraprofessionals, volunteers, and those
whose practice is embedded within other
occupational roles
Public perception: inaccessible, expensive, middle Public perception: accessible, free, working
class class
Perception by government/State: given prominent Perception by government/State: largely
role in mental health services; strongly supported invisible
by evidence-based practice policies
Conceptualizes the client as an individual with Conceptualizes the client as a person in a social
problems in psychological functioning context
Training and practice focuses on delivering Training and practice involves not only
interventions delivering interventions, but also working with
embedded colleagues, and promoting self-help
Psychotherapy agencies are separate from the Counselling agencies are part of their
communities within which they are located communities (e.g. a student counselling
service in a university)
Treatment may involve the application of The helping process typically involves
interventions defined by a protocol, manual or counsellor and client working collaboratively,
specific therapy model using methods that may stretch beyond any
single protocol or manual
Treatment has a theory-derived brand name (e.g. Often has a context-derived title (e.g.
interpersonal therapy, cognitivebehavioural workplace counselling, bereavement
therapy, solution-focused therapy) counselling, student counselling)

(Continued overleaf )
198 The counsellors workbook

Psychotherapy Counselling

Many psychotherapists have a psychology degree, Counsellors are likely to be drawn from a wide
which functions as a key entrance qualification variety of backgrounds; entrance qualification
is life experience and maturity rather than any
particular academic specialism
Predominant focus on the pathology of the person Predominant focus on personal strengths and
resources

Where do you position yourself in relation to these therapeutic traditions? What are
the implications for your future career development and training? What are the implica-
tions for what you say to your clients about how you will work together, the kind of
therapy goals that you negotiate and the contract that you make?

Further reading
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(Preface and Chapters 1 and 2).
199

Your therapy room

The physical environment in which therapy takes place is an important, but seldom
acknowledged, element of the counselling process. The furnishing and layout of a
counselling room both raises expectations and sets limits regarding the ways in which a
client can express him or herself, how safe he or she feels, the extent to which move-
ment is possible, and much else. The location of the room the building, how access-
ible it is, what the waiting area is like also sets the scene for the type of therapeutic
work that can occur.
Imagine your own ideal therapy room. In designing your therapeutic space, consider
the following questions:
G What kind of building is the room in? Where is the building? What are the
surroundings?
G How is the waiting area furnished and laid out? What does the client do while
waiting?
G How is the therapy room furnished and laid out? What objects and images are in
the room?
G What use is made of texture, colour, design, fragrance, sound, etc.?
You may find it useful to make a sketch of this space.
Once you have constructed your image of an ideal therapy environment, reflect on
these further questions:
G What are the main differences between your ideal therapy room and counselling
spaces that you have visited or worked in? What does this comparison tell you
about possible goals for the future?
G What have you learned about yourself and your personal approach as a counsellor
from this exercise? To what extent could your ideal therapy room be understood as
a projection of your core values as a counsellor?
G In what ways does your design reflect the concepts and assumptions of your
preferred theoretical approach(es)?
200

Building an effective
support network

A critical aspect of developing a sense of professional identity as a counsellor or psy-


chotherapist involves finding ways of dealing with the stress and pressure that can result
from this kind of work. The construction of survival strategies depends to a large extent
on the existence of a support network, comprising colleagues, therapists, supervisors
and other people who can contribute to the maintenance of worklife balance.
The purpose of this learning task is to invite reflection on the elements of your own
personal, actual or intended support network, and to consider the ways in which this
network reflects or expresses your identity as a therapist.

Reflecting on your position in relation to supervision


G Write a character sketch of your ideal supervisor.
G Write a character sketch of what would be for you the supervisor from hell.
G What do you need from supervision? What are you looking for?
G What would it take (has it taken) to make you change your supervisor?

Reflecting on your position in relation to personal therapy


G Write a character sketch of your ideal therapist.
G Write a character sketch of what would be for you the therapist from hell.
G What do you need from your own therapy? What are you looking for?
G What would it take (has it taken) to make you enter therapy?

Stress and coping


G What do you find most stressful in your work?
G What activities do you find most satisfying and nurturing in your work?
G What strategies do you employ to cope with stressful aspects of your work?
G What would it take to make you review these strategies?
Make some notes in response to the questions listed above. Once you have done some
writing, consider the following additional issues:
G How well are you supporting yourself?
G What impact does the kind of support network you have constructed have on your
work with clients?
Developing a professional identity 201

G What impact does the kind of support network you have constructed have on your
life outside your work?
G What does your support network say about who you are, and what you stand for, as
a counsellor?

Further reading
Dryden, W. (ed.) (1994) The Stress of Counselling in Action. London: Sage.
Horton, I. (ed.) (1997) The Needs of Counsellors and Psychotherapists: Emotional, Social, Phys-
ical, Professional. London: Sage.
Skovholt, T.M. (2001) The Resilient Practitioner: Burnout Prevention and Self-care Strategies.
Boston, MA: Allyn & Bacon.
Weaks, D. (2002) Unlocking the secrets of good supervision, Counselling and Psychotherapy
Research, 2: 339.
202

Your position in relation to


research and inquiry

The primary focus of this Workbook has been to integrate the theory and practice of
counselling within the narrative of your own personal life experience, with the goal of
creating a knowledge base that is firmly grounded in your everyday reality. However,
it is important to acknowledge that there exists another knowledge base, which lies
outside of personal experience the knowledge that can be derived from systematic
research.
In recent years, counselling and psychotherapy research has evolved in the direction
of what is known as methodological pluralism. In the past, research tended to mean
statistics and experiments. Now, research and inquiry draw on personal experience,
interviews, action, stories, and much else. Current research therefore represents a
potentially rich source of knowledge for practitioners.
What is your relationship with the knowledge base represented by systematic
research and inquiry? Take some time to write your responses to the following questions:
G In principle, how important do you think research is in relation to counselling and
psychotherapy? What are the reasons for being interested in research at all?
G What are your criticisms of therapy research? What should or could researchers do
in order to make research more relevant or useful?
G In what ways do you use research to inform your practice? List some research
reports that you have recently read. How have these influenced how you think
about your work as a counsellor?
G How do you access research? How often do you read about research findings?
G If you were in a position to have some free time to do research, which questions
or topics would interest you?
Once you have responded to these questions, reflect on what you have discovered
about who you are as a counsellor, and also about future directions that your career or
interests might take.

Further reading
The main themes and methods in contemporary research in counselling are examined in:
McLeod, J. (2009) An Introduction to Counselling, 4th edn. Maidenhead: Open University Press
(Chapter 18).
Overviews of the methods and findings of current counselling and psychotherapy research are
available in:
Cooper, M. (2008) Essential Research Findings in Counselling and Psychotherapy: The Facts are
Friendly. London: Sage.
Timulak, L. (2008) Research in Counselling and Psychotherapy. London: Sage.
203

What does it mean to be


personal?: some questions
from Carl Rogers
In On Becoming a Person, Carl Rogers (1961) consistently returns to the theme that it is
the person of the counsellor, and his or her capacity to enter into a non-judgemental
relationship with the client, which makes a difference. Many passages in this book read
like a conversation, with Rogers engaging in dialogue with aspects of his own experi-
encing, and attempting to open dialogue with his readers.
In Chapter 3, Rogers asks a series of questions that remain meaningful to anyone
seeking to develop a personal approach to counselling:
Can I be in some way which will be perceived by the other person as
trustworthy, as dependable or consistent in some deep sense?
Can I be expressive enough as a person that what I am will be com-
municated unambiguously?
Can I let myself experience positive attitudes towards this other per-
son attitudes of warmth, caring, liking, interest, respect?
Can I be strong enough as a person to be separate from the other?
Am I secure enough within myself to permit his or her separateness?
Can I permit him or her to be what he or she is?
Can I let myself enter fully into the world of his or her feelings and
personal meanings and see these as he or she does?
Can I accept each facet of this other person when he or she presents it
to me?
Can I act with sufficient sensitivity in the relationship that my
behaviour will not be perceived as a threat?
Can I free the other from the threat of external evaluation?
Can I meet this other individual as a person who is in the process of
becoming, or will I be bound by his past and by my past?
In the light of what you have written in response to other activities in this Workbook,
and referring also to other relevant learning experiences, reflect on the following
questions:
G Do Carl Rogers questions capture for you an adequate sense of what it might mean
to use a personal approach in your work as a counsellor? If not, which questions
would you add, delete or reword?
G Where are the areas of personal challenge for you in relation to these aspects of a
personal approach?
204

Ten years from now

Imagine that the date is 10 years in the future. You have achieved all the main goals that
you set yourself at the end of your period of training as a counsellor or psychotherapist.
You are in a peer support group, which has decided to devote a couple of sessions to
giving each member time and space to review their career. You are being interviewed by
these close colleagues, and invited to explore the following questions:
G How do you sum up your work now who you are in terms of your professional
identity, where and how you work, and the approach you take?
G In what ways is this current situation different from your working life 10 years ago?
G What have been the main challenges and choice points for you during the last
10 years?
G What have been your main sources of support and assistance that have enabled
you to achieve your aims?
G What are the most important things you have learned over this period of time?
G How have you changed, and how have you remained the same as a person?
G What would you like to say to the you of 10 years ago?
Once you have responded to these questions, take some time to reflect on the
implications of this piece of time travelling for your professional identity now.
205

Critical issues for


counselling and
psychotherapy
The closing chapter of McLeod (2009) discusses a number of critical issues that the
counselling and psychotherapy professions will be required to address and resolve
within the next two decades.
These critical issues include:
1 developing ways of helping people to explore and adjust to the impact of global
warming and the destruction of the natural environment;
2 being able to incorporate into practice, innovations and advances in technology
(e.g. Internet, biotechnology);
3 developing forms of therapeutic practice that take account of the place of spir-
ituality in human experience;
4 resolving the debate or standoff between the movement towards an integrated
approach to theory and practice, versus the existence of separate schools of
therapy;
5 developing an identity for counselling as an activity distinct from psychotherapy;
6 constructing an appropriate knowledge base for practice and service delivery in
counselling;
7 adopting the concept of learning as a root metaphor for theory and practice
(rather than the medical model metaphor of intervention);
8 moving from a pathology-oriented to a strengths-focused approach to clients;
9 maximizing client/user involvement in the design and delivery of services;
10 taking seriously the implications of the capacity for therapy to do harm.
Do you agree that these are the central issues of policy and practice that will be facing
the counselling and psychotherapy professions during the next phase of your career? If
not, what other critical issues do you believe will be more salient?
Identify two or three critical issues that seem most important to you. What position
do you adopt in relation to the direction that the profession should take in respect of
these issues? What might the barriers be to achieving change around these issues? What
are the forces that are pressing for change?
What are the implications of these particular issues for the shape and direction of
your career? How do you see your own role in relation to contributing to the efforts of
the profession collectively to work through these particular issues? How do you feel in
yourself about your capacity to make a difference? What can you do in the immediate
future to take forward your active involvement in this area?
Internet resources and
further reading

One of the recurring themes that weaves through this Workbook is the idea that becom-
ing a counsellor is like being on a journey. This is a lengthy journey to develop a sense
of competence, and a secure professional identity as a counsellor can take between
three and five years. The most important type of assistance that anyone can have on a
journey is other people, such as guides and mentors, fellow travellers. But there are
other resources that can be helpful too. In this section, some suggestions for potentially
useful tools for a counsellors journey are assembled.

Internet resources
There is an ever-increasing range of websites that carry information about theory,
research and practice in counselling and psychotherapy. An up-to-date set of links can
be found through the website for this book: www.openup.co.uk/mcleod.

Therapy thrillers
It is worth while asking experienced counsellors and psychotherapists about spe-
cial books that have inspired them. Sometimes they will mention serious theoretical
books. Very occasionally they may refer to books that are research-based. But
most often, they will point you in the direction of therapy thrillers gripping stories
that are drawn from personal experience. Some of the most popular books in this
category are:

Axline, V. (1971) Dibs: In Search of Self. Harmondsworth: Penguin. A case study of play therapy
with a young boy captures the spirit of the client-centred approach.
Galloway, J. (1999) The Trick is to Keep Breathing. New York: Vintage. A book that explores the
experience of a mental breakdown.
Jamison, K. (1996) An Unquiet Mind. New York: Vintage Books. A famous psychologist writes
about her personal battle with manic-depressive disorder.
Peck, M.S. (1978) The Road Less Traveled: A New Psychology of Love, Traditional Values and
Spiritual Growth. New York: Simon & Schuster. A book that many therapists have found highly
meaningful as a source of inspiration regarding the possibility of growth and change.
Yalom, I. (1989) Loves Executioner and Other Tales of Psychotherapy London: Penguin. Stories
about therapy cases (Yalom has also written novels on therapy themes google his website for
more information).

206
Internet resources and further reading 207

The experiences of people undergoing therapy training


There are always stages in a long journey that are demanding, exhausting or hazardous.
At these times it can be useful to know that other people have travelled the same road,
and survived. There are several excellent books that have brought together trainees
accounts of aspects of the experience of becoming a counsellor:
Alred, G., Davies, G., Hunt, K. and Davies, V.H. (eds) (2004) Experiences of Counsellor Training:
Challenge, Surprise and Change. London: Palgrave Macmillan.
Buchanan, L. and Hughes, R. (2001) Experiences of Person-centred Training: A Compendium of
Case Studies to Assist Prospective Applicants. Ross-on-Wye: PCCS Books.
Dryden, W. and Spurling, L. (eds) (1989) On Becoming a Psychotherapist. London: Tavistock/
Routledge.
Dryden, W. and Thorne, B. (eds) (1991) Training and Supervision for Counselling in Action.
London: Sage.
Johns, H. (ed.) (1998) Balancing Acts: Studies in Counselling Training. London: Routledge.
Noonan, E. and Spurling, L. (eds) (1992) The Making of a Counsellor. London: Routledge.
Skovholt, T.M. and Ronnestad, M.H. (1995) The Evolving Professional Self: Themes in Counselor
and Therapist Development. New York: Wiley.
White, C. and Hales, J. (eds) (1997) The Personal is the Professional: Therapists Reflect on their
Families, Lives and Work. Adelaide: Dulwich Centre Publications.

Applied wisdom: learning from those who have been there


A particularly interesting area of research, pioneered by Thomas Skovholt, Len Jennings
and Helge Ronnestad, has examined the experiences and characteristics of therapists
who have been successful within the profession in the sense of being recognized by
their colleagues as the best of the best, or who have worked as therapists for a long
time, and are able to look back on a rich and varied career. These studies have been
written up in an accessible and stimulating manner, and have a lot to offer to anyone
seeking to know more about the realities of a career as a therapist.
Ronnestad, M.H. and Skovholt, T.M. (2001) Learning arena for professional development: retro-
spective accounts of senior psychotherapists, Professional Psychology: Research and Practice,
32: 1817. This article is an analysis of interviews with some very experienced therapists.
Skovholt, T.M. (2001) The Resilient Practitioner: Burnout Prevention and Self-care Strategies.
Boston: Allyn & Bacon. This book considers the implications of research in terms of strategies
for surviving the stress of being a counsellor.
Skovholt, T.M. and Jennings, L. (eds) (2004) Master Therapists: Exploring Expertise in Therapy and
Counseling. Boston, MA: Allyn & Bacon. Examines the attitudes and competences of therapists
considered to be the leaders of the profession.
A similar set of resources that brings together some of the wisdom of experienced therapists is the
series of books by Jeffrey Kottler, for example:
Kottler, J. and Carlson, J. (2003) Bad Therapy: Master Therapists Share their Worst. Hove: Brunner-
Routledge.
208 The counsellors workbook

Kottler, J. and Carlson, J. (2005) The Client who Changed Me: Stories of Therapist Personal Trans-
formation. London: Routledge.
Another distillation of a lifetime of therapeutic experience can be found in:
Yalom, I. (2002) The Gift of Therapy: Reflections on Being a Therapist. London: Piatkus.

Personal development guidebooks


There are other books that, like this Workbook, provide reading material and learning
activities that are designed to encourage the development of a personally grounded
approach to counselling. Particularly recommended are:
Corey, M.S. and Corey, G. (2003) Becoming a Helper, 4th edn. Pacific Grove, CA: Brooks/Cole.
Cross, M.C. and Papadopoulos, L. (2001) Becoming a Therapist: A Manual for Personal and
Professional Development. Hove: Brunner-Routledge.
Appendix A: A narrative
approach to personal and
professional development in
counselling/psychotherapy
training

Almost all counselling and psychotherapy training programmes in the UK incorporate


some element of experiential work in small groups. A variety of labels are used to
describe these activities: personal development, personal and professional develop-
ment, group therapy, self-awareness, home groups, and so on. Depending on the over-
all aims, structure and theoretical orientation of the programme, such groups may serve
a range of functions including:
G developing personal self-awareness and addressing personal issues;
G developing awareness of self in the professional role of being a therapist;
G providing a context for mutual support for students engaged in a demanding pro-
gramme of study;
G fostering a sense of community;
G enabling participants to learn about the dynamics and functioning of small groups.
In general, this kind of group is not used as an arena for didactic inputs or for discussions
of course management matters such as the quality of teaching or library provision the
learning process is primarily experiential and participative. Although the performance
of a student or trainee in the experiential group and the learning that takes place are
acknowledged as central to the training process, it is usual that the experience is not
directly assessed. In recognition of the fact that that it is important for participants to
experiment within the group, and be honest, assessment will normally take the form
of a reflective report written by the student or trainee, rather than being based on direct
assessment of behaviour within the group itself. There appear to be many different ways
of organizing experiential groupwork on counselling and psychotherapy training
courses. For example, the time devoted to this kind of activity can vary. In some
programmes, groups are facilitated by core tutors/trainers. In others, independent
external facilitators are used. In some settings, the group operates on a peer facilitation
basis. Groups also vary in the degree to which they make use of exercises and activ-
ities, or are unstructured. Finally, there are differences in the extent to which partici-
pants are provided with formal opportunities to make theoretical sense of the group
experience.
There seems to be little recent research on the effectiveness of experiential learning
groups on counselling and psychotherapy courses in terms of their contribution to
the development of therapist competences. Discussion of the issues involved in such
groupwork can be found in Johns (1998, 2002), Lago and Macmillan (2000), Mearns

209
210 The counsellors workbook

(1997) and Rose (2008). One of the themes that emerges from this literature is that
participants are often unclear about what they are meant to be doing in the group, and
how the group experience is linked to the broader goal of becoming a counsellor or
psychotherapist. While students and trainees are usually clear about the value of per-
sonal therapy, as a means of developing self-awareness and learning about therapeutic
process, in many instances they are less convinced about the value of the experiential
group, which they view as uncomfortably straddling a boundary between therapy
and training. As a result, there is a sense on the part of many students and trainees that
their experiential group represented a frustrating experience, which did not deliver what
they expected or needed, in the context of the amount of training time that was devoted
to it.
A narrative approach to personal and professional development groups in counsel-
ling and psychotherapy training has the potential to address many of these issues. A
narrative approach is constructed around the central idea that effective therapists need
to possess a detailed understanding of their own personal history, and the way in which
their life story both impacts on clients, and is affected by the clients story. No matter
what therapeutic theory or model is being used, it is necessary for a practitioner to
possess a personal understanding of what it means and how it operates; techniques and
concepts are conveyed to the client through the person or the practitioner. From this
perspective, the key personal and professional development questions that need to be
explored during training are:
G who am I as a therapist?
G what do I bring from my personal experience of life to the role of therapist?
G what meaning do therapeutic concepts have for me personally in relation to their
capacity to enable me to live a good life?
In order to make pragmatic use of the answers to these questions, in terms of being able
to work effectively with clients, it is necessary that the personal understanding that
emerges is sufficiently comprehensive, in taking account of all relevant aspects of life
experience, and sufficiently coherent, in offering a life story that makes overall sense
rather than being confusing and contradictory.
A narrative approach to experiential learning groups is based around autobiograph-
ical exploration (thickening my story of who I am). The process incorporates reflection
on practice that allows meaningful links to be made between current experience and
the broader life story. This kind of learning can take place in many different settings;
for example, keeping a personal journal, seeing a therapist, consultations with tutors,
conversations with friends and family members. The distinctive function of the small
group, in relation to this activity, is that it represents a setting in which the person hears
other course members tell their stories, which is helpful in enabling connections to be
made between personal experience and broader patterns of shared cultural experience.
The small group is also a place in which the person can be called to account; for
example, if he or she describes him or herself in ways that contradict the ways in which
he or she is experienced by other members of the group.
In practice, a learning or experiential group operating along narrative lines functions
by taking one of the learning tasks in this Workbook each week, and using that as the
focus for the session. Members of the group are expected to write about the activity in
Appendix A 211

their personal learning journal, and then to take turns in the group to report back what
they have written, to talk spontaneously on the topic, or to reflect on the experience of
exploring the topic. Depending on how much time the group wishes to allocate to each
topic, and how many members there are, each report may be followed by a round of
responses and reflections, using the format described in the Making connections and
being responsive to others exercise (Section 2). Alternatively, each member may simply
make their report in turn, with responses and reflections being made once the whole
round has been completed. Following the group session, the student or trainee
privately reflects further on the topic in his or her personal learning journal. Over time,
each member accumulates a rich and detailed autobiographical account in their
personal learning journal. Key aspects of this autobiography are shared with other
members of the group, thus providing a potentially profound experience of being
known. In addition, this structure offers plentiful experience in the process of respond-
ing to life stories, making connection, and being responded to. The responses of other
group members function as a kind of reflecting team (Andersen, 1987; White, 1995)
whose offerings may help the initial speaker to develop a reflective stance in relation to
his or her own story.
The structure of a narrative-informed learning group or personal and professional
development group will depend on the circumstances in which it meets in terms of time
available, number of members and facilitator role. It may be useful to plan for the work
of the group as passing through three stages:

Stage 1: beginning the group: Introductions, review aims and information that has been
provided to members about the aims and functioning of the group, agree on a set of
ground rules for the operation of the group, plan for initial group tasks;

Stage 2: working together on learning about self. Work through learning tasks, week by
week choice and sequence of tasks decided by the group; regular reviews of the
functioning of the group/revisiting ground rules;

Stage 3: reflecting on the experience of being in a group. The group journey exercise
and other ending activities.

The structure of weekly sessions might incorporate: (a) report in anything you
want to say to other members of the group; check out who is absent and why, and
so on; (b) the weekly learning task; (d) planning for future sessions; and (e) closing
reflection unfinished business, feedback (resentments and appreciations).
It is open to the group to decide to adapt or modify this structure to meet its needs at
any particular point. For example, groups may wish to include unstructured sessions to
allow a more open and spontaneous expression of feeling and interaction. If a group
feels stuck, it may be helpful to devote one or more sessions to reflecting on the
dynamics of the group, reviewing ground rules, and so on. A group may opt to spend
more than one week on a topic, or to devise its own topics and activities. Flexibility and
creativity are encouraged, as long as they contribute to the achievement of the overall
goals of the group experience. The group needs to operate within the usual standards of
ethical good practice around confidentiality, consent, autononomy, fairness, respect,
212 The counsellors workbook

and so on it is up to each group to work out what these ethical principles should
operate in their specific context.
The primary role of the facilitator is to contribute to maintaining the boundaries of
the group (start and finish on time, ensure that the room is appropriately equipped, deal
with any intrusions, and monitor and address any possible confidentiality breaches).
The facilitator also works with the group to establish a set of ground rules for the
operation of the group, and to review these where necessary, and facilitates the process
of learning within sessions; for example, by making sure that enough time is devoted to
each member, encouraging the participation of group members, and if appropriate
reflecting on the process of the group. The facilitator also has a role as a representative
of the training team to monitor the well-being of group members, and if necessary to
arrange individual meetings outside the group to share concerns.
The process of a learning group will be influenced by the stage of training of group
members. Students or trainees at an early stage of training can be viewed as learning
about what is involved in using a group to enhance self-exploration. By contrast, those
at a more advanced stage of training are in a position to adapt the group format to meet
their self-identified learning needs and priorities (see Table A.1.1):

Table A.1.1. Personal development goals at different stages of training


Introductory stage of training Advanced stage of training
Likely to be students only involvement Students are likely to be engaged in several different forms of
in personal development work, other personal development work: personal therapy, supervision,
than writing a personal learning keeping a personal journal, consultation with course
journal colleagues
Aim is to learn how to make use of Aim is to reflect on and integrate different types of awareness
self-awareness activities activity into a coherent account of who I am as a counsellor
More freedom to experiment course More pressure to present a competent self assessment
assessment load is relatively light, and pressure is higher, and lack of success on course may have
consequences of not doing well are significant consequences in terms of professional
minimal accreditation. As a result, group participants may need to work
harder to achieve a sufficient level of trust and safety
Individual self-awareness is primary Learning about group process is a central goal, in addition to
goal the development of individual self-awareness
Group members learn how to support Group members learn how to both support and challenge each
each other other

The movement from early to later stages of training leads to different emphases
within a learning group. At a later stage, members are more engaged in a relational
experience in which they reflect on their identity in relation to other members of the
group. It may be useful to support this learning by providing students with opportunities
to learn about models of group dynamics, or to explore relationally oriented models of
therapy. By contrast, for students and trainees entering this kind of learning environment
for the first time, there can be a great deal of immediate personal learning as the person
explores certain topics for the first time, or may experience for the first time a sense of
affirmation and acceptance in a group context. Participants at an introductory stage of
Appendix A 213

training are unlikely to have much basis on which to make decisions about which topics
the group might address. For these participants, it may be helpful for the facilitator to
take a clear lead in suggesting topics and ground rules. For more advanced participants,
who have more experience of how groups work, and more ideas about their own
learning needs, the group can become a co-constructed, negotiated, improvised and
flexible experience. The Counsellors Workbook includes a sufficient number of learn-
ing tasks for facilitators and group members to be able to select what seems right for
them at any particular time. Group members and facilitators may also generate new
learning tasks that correspond to the particular interests of group members, or the
cultural milieu in which the group and the training course takes place. There may be
times when it can be valuable for members of a group to return to a learning task that
had been explored in the past, as a means of mapping the personal journeys in which
members have been engaged.
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Index

abstract conceptualization 45 behaviour, changing 37


abuse, sexual 141, 157 beliefs 57
academic disciplines 79 irrational 90, 98
acceptance 9, 312, 53, 66 personal philosophy 1556
active experimentation 45 belonging 66, 192
activism 100 bereavement counselling 114, 174
activist learning style 45 Berne, Eric 168
activities 196 Bettelheim, Bruno 168
Adler, Alfred 24 bibliotherapy 1767
affection, need for 66 biographies of theorists 1056
agony aunts 179 biology 75
altruism 62 borderline personality disorder 145
Amazon 176 boundaries
anal personality 77 of a group 67, 212
anger 128 meaning of 172
anxiety 1356, 157 boundary violations 1334, 172
approaches to counselling/psychotherapy 9, 73, breathing difficulties 126, 128, 141
119 British Association for Counselling and
applying to personal experience 812 Psychotherapy 159
CBT 73, 85, 8891, 103, 163, 192 Burns, G.A. 181
humanistic 94, 115, 165
person-centred see person-centred approach Campbell, Warihi 192
personal approach see personal approach to Carrell, Susan 194
counselling case formulation 91
psychoanalysis 101, 103, 115, 163, 165 case studies 87, 119
psychodynamic 73, 101, 115, 163, 165 catharsis 62, 103
approval, parental 124 challenge 53
artistic expression 79 challenging irrational beliefs/dysfunctional
assessment 1112, 209 self-talk 98
assignments 1112 challenging clients 34, 53, 159, 1856
assumptions change
implicit 7 experience of changing behaviour 37
informing ones worldview 98 group dynamics 68
attachment difficulties 61 relative importance of cognition and emotion
attraction, sexual 25, 116, 160 1034
authentic presence, therapist as 108 child development 110, 168
authenticity 92 childhood
experiencing 945 experiences 105
autobiographical writings 17, 21011 memories 24, 137
early memories 24 children 159
making sense of 812 choice map 389
avoidance 89 chronic fatigue syndrome 145
Clarkson, Petruska 1089
background reading 11 classical conditioning 889
Balint, Michael 42 claustrophobia 136, 145
basic fault 42 client-therapist relationship see therapeutic
Beck, Aaron T. 103 relationship
Bedi, R.P. 162 client groups 154

221
222 Index

clients meaning in the community 173


difficult 34, 53, 159, 1856 personal experience of 26
maximizing involvement of 205 counsellor/therapist 3
moral dilemmas presented by 1578 boundary violations by 1334, 172
opening statement 1223 congruence 923, 98
readiness 5 contribution to counselling 278
re-authoring letter to the client 98 effectiveness 1834, 1923
transference 11516 group as a context for exhibiting qualities and
coach, therapist as 108, 163 competencies of 65
codes of ethics 159, 161 importance of character and personality 12
cognition 75 marketing of 196
dysfunctional 90, 98 metaphors for 108, 163
relative importance of cognition and emotion in origins and development of interest in therapy
change 1034 20
cognitive-behavioural therapy (CBT) 73, 85, personal approach see personal approach to
8891, 103, 163, 192 counselling
case formulation 91 personal qualities 9, 190
classical conditioning 889 reviewing skills and qualities 190
irrational beliefs and dysfunctional self-talk 90 toolbox 1945
operant conditioning 88 training see training
cognitive schema 73 way of working and moral values 154
cohesiveness, group 62 counsellors journey 20, 28
Combs, Arthur 155 counter-transference 92, 98
commitments 57 couple counselling 157, 159
common factors 989 creativity 79
community crises, coping with 36
meaning of counselling in 173 critical issues 205
moral communities 152 cultural identity 2930
competence 190 and personal approach to counselling 107
composition, group 67 culture 75, 105
concentration problems 1356 group culture 645
concrete experience 45 meaning of counselling and psychotherapy
conditioning 889 173
confidentiality 67, 57, 160
deconstruction of meaning 161 decision-making, ethical 15960
congruence 53, 923, 98 dependency 11516
connections 578 dependency needs 66
consciousness 85 depression 1356, 13940, 146
consent, informed 160 development
contact with others 47 child development 110, 168
container, therapist as 108, 163 personal 54, 20913
contradictory impulses 101 story of a development in ones life 578
control 66 dialogue 203
coping 200 imaginary dialogue between theorists 11011
with crises 36 difference 53
under pressure 44 engaging with 345
core conditions model 77, 110 difficult clients 34, 53, 159, 1856
core issue 42 direction 163
core and peripheral self 85 discovery 47
CORE system 192 dissociation 145
counselling 10 diversity of perspectives 173
comparison with psychotherapy 1978 downplaying 191
counsellors contribution to 278 dreams 98
critical issues 205 working with 171
images of 191 dysfunctional thinking/self-talk 90, 98
Index 223

early memories 24 feelings


editor, therapist as 108 about a learning group 55
effectiveness 1834 feeling wanted and needed 47
criteria for evaluating 1923 need to express 66
ego, emptying of the 1089 first impressions 5960
Ellis, Albert 90, 103 frame of reference, internal 83
email 180 framework for understanding 3, 4, 734
emotional climate 64 Freud, Sigmund 23, 105
emotional pressure 44 transference 115
emotions 75 the unconscious 101
case scenarios for working with emotions 145 functional analysis 88
relative importance of cognition and emotion in future, the 204
change 1034
self-exploration of personal emotional patterns Gendlin, E.T. 92
401 generalization 89
stories and significant emotions 167 genetics 75
empathic reflection of meaning 98 genogram 29
empathy 53, 834, 110 genuineness 92
employee assistance programme (EAP) 132 gifts 159
endings, group 645, 68 giving something back 47
environment, natural 205 global warming 205
Erikson, Erik 110 good life, vision of 152
ethical decision-making 15960 ground rules 55, 212
ethical principles 21112 group cohesiveness 62
see also morality group dynamics 669, 211
existential awareness 62 change 68
existential psychotherapy 194 group as a system 67
expectations of learning group 55 group roles and leadership 678
experience needs of individual members 66
concrete 45 group facilitation 53, 209, 212
personal see personal experience group norms 55, 645, 67
practical 3, 45 group roles 55, 56, 65, 678
portfolio of experiences and reflections 79 groups
previous 278 helpful factors in 62
responsiveness to others 578 learning groups see learning groups
vicarious 47 mapping your relationship patterns 33
experiential learning 11, 45 therapeutic factors 62
experiential learning groups 8, 54, 20913 guidance 62
experimentation
active 45 habits 88
new ways of relating to others 56 Haley, Jay 183
extinguishing connections 89 harassment 143
harm, capacity to cause 205
facilitation, group 53, 209, 212 healing 47
failure metaphors 169
feelings of 1201, 1356 hearing voices 1301
therapeutic failure 1834 help 47
fairy tales 167, 168 helping relationship story 19
family re-enactment 62, 65 receiving 26
family roles 56 high direction/high support mode 163
family tree 29 high direction/low support mode 163
fantasies 55 highlighting 191
favourite story 212, 1678 Hill, Clara 171
fear 889 home 30
feedback 9, 53, 62 honesty 9, 55, 92
224 Index

Honey, Peter 45 leadership 678


hope 62 style 64
Howard, G.S. 163 leaflets 196
hugging 160 learning 10, 205
humanistic approach 94, 115, 165 core aspects of learning about counselling/
psychotherapy 35
id, the 101 experiential see experiential learning;
ideal therapy room 199 experiential learning groups
identification 62, 83 individual 6
identity style 456
cultural 2930, 107 learning alliances 67
professional 89, 189 learning groups 45, 67, 11, 5169, 119
images exploring feelings, fantasies and expectations
of counselling/psychotherapy 191 about 55
of the world 167 first impressions of group members 5960
immediacy 92 narrative approach to personal development
implicit assumptions 7 groups 54, 20913
impression management 59 reflecting on the life of the group 645
inclusion, need for 66 reflecting on significant events in 623
independent study 11 talking about oneself in 61
individual learning 6 see also group dynamics
influence 66 learning journals 56, 7, 11, 18, 56, 114,
informed consent 160 21011
insight 81, 103 learning tasks 5, 11
instrumental conditioning 88 letters
integration of theory and practice 8, 205 re-authoring letter to the client 98
intellectual challenge 47 to significant others 1745
intentions 57 to theorists 114
internalized self objects 85 levels of abstraction 778
Internet Lewin, Kurt 76
online counselling 180 liberation 192
resources 178, 206 libido 77
interpersonal needs 66 life choices 389
interventions toolbox 1945 case study 1245
intimacy 65, 66, 116 life experiences 27
intimidating clients 34, 53, 159, 1856 liking, need for 66
intuition 59 local resources 9
irrational beliefs 90, 98 Lomas, Peter 1, 2, 44, 107
Lott, Deborah 109
Jennings, Len 108, 207 low direction/high support mode 163
journal, learning 56, 7, 11, 18, 56, 114, low direction/low support mode 163
21011 Luborsky, Lester 167
journey
counsellors 20, 28 magazine problem pages 179
group 64 maintenance 89
Just Therapy centre 192 maps/mapping
choice maps 389
kissing 160 relationship patterns 33, 109
knowledge, previous 278 marketing oneself 196
knowledge base 202, 205 master therapists 119, 2078
Kolb, David 45 McConnaughy, E.A. 1
Kvale, Steiner 112 Mearns, D. 92, 94
media 179
language 112, 169, 191 medical problems
last resort, therapy as 13940 counsellors disclosure dilemma 159
Index 225

physical symptoms 1269, 141 responsiveness to 578


terminal illness 122, 160 significant 1745
Meichenbaum, Donald 90, 169 outcome criteria 1923
memories 17 outdoor therapy 1812
early 24
mentors 10 pain symptoms 1269
metaphors panic attacks 128
for counselling and psychotherapy 191 parental approval 124
for counsellor/psychotherapist 108, payment 47
163 peer group 10
working therapeutically with 16970 peer learning groups 4, 6, 11, 53, 209
meta-theories 7980 see also learning groups
methodological pluralism 202 Pennebaker, James 48
modernity 112 people orientation 155
moral communities 152 peripheral and core self 85
morality 9, 151 person-centred approach 73, 103, 115, 155, 163,
ethical decision-making 15960 192
ethical good practice 21112 clients frame of reference 83
exploring moral values 1523 congruence 92, 94
moral dilemmas presented by clients personal approach to counselling 151
1578 cultural identity and choice of 107
moral values and personal approach to explaining/describing 196
counselling 154 moral values and 154
Morgan, A. 15 Rogers questions 203
motivation 47 personal development groups 54, 20913
moving on in life 1434 personal development guidebooks 208
multiplicity of self 85 personal experience 10, 15
of changing ones behaviour 37
narcissism 61 of counselling/therapy 26
narrative approach to personal development of crisis 36
groups 54, 20913 theory and making sense of 812
narrative therapy 96, 114 personal gain dilemma 159
natural environment 205 personal learning journal 56, 7, 11, 18, 56, 114,
nature-guided therapy 1812 21011
Navajits, Lisa 191 personal learning styles 456
needs, interpersonal 66 personal philosophy 1556
new start 1434 statement of 12
New Zealand 192 personal qualities 9, 190
non-specific factors 989 personal struggle 42
norms, group 55, 645, 67 personal therapy 7, 8, 200, 210
not-knowing stance 108 personal writing 1516, 48
notebooks 18 perspectives
continual change 112
object relations theory 85 diversity of 173
observational concepts 77 philosophical assumptions 78
one-minute intro 196 philosophy 79
online counselling 180 physical symptoms 1269, 141
opening statement 1223 political ideologies 79
openness 92 politics 100
operant conditioning 88 portfolio 5
order, need for 66 assessment 1112
others of experiences and reflections 79
beliefs about 155 postmodernism 11213
contact with 47 power 47
experimenting with relating to 56 need for 66
226 Index

practical experience 3, 45 relationships 10


practice boundaries 172
integration of theory and 8, 205 breakdown 132, 143
reflection on 151, 21011 clients problems in 1378
setting 154 between group members 65
pragmatist learning style 45 making connections and being responsive to
preferred learning style 456 others 578
presence 92 mapping your relationship patterns 33,
pressure, coping under 44 109
previous knowledge/experience 278 stories and pattern of 167
priorities 155 therapeutic relationship see therapeutic
privacy 7, 18 relationship
problem focus 96 writing about a helping relationship 19
problem pages of magazines 179 release, emotional 103
professional codes of ethics 159, 161 religion 79
professional development 20913 research 202
see also training resonance 92
professional identity 89, 189 respect 7, 47
propositions 77 responsibility 7, 57
proverbs, moral 152 responsiveness to others 578
psychoanalysis 101, 103, 115, 163, 165 ritual 18
psychodynamic approach 73, 101, 115, 163, 165 Rogers, Carl 43, 92, 105, 110, 123
psychopathology 42 empathy 83
psychosocial development 110 questions relating to personal approach 203
psychotherapy roles
comparison with counselling 1978 family 56
critical issues 205 group 55, 56, 65, 678
images of 191 Ronnestad, Helge 207
meaning in the community 173 room, therapy 20, 199
origins of interest in 20 routine 18
purposes, beliefs about 155 Rowan, J. 43

qualities, personal 9, 190 sacredness 192


satisfaction 47
race 122 sayings, moral 152
readiness, clients 5 schema 73
reading scientist, therapist as 108
background 11 self 73
therapeutic use of 1767 beliefs about 155
re-authoring letter 98 making sense of 856
receiving help 25 sense of 23
reflection 45 taking care of oneself 7
on the experience of writing about oneself use of 923
489 work on 4
on the life of a group 645 self-acceptance 85
on personal experience 4 self-actualization 77, 85
portfolio of experiences and reflections 79 self-awareness 34, 6
on practice 151, 21011 self-blame 1467
on significant events in a group 623 self-concept 85
reflection of meaning, empathic 98 self-disclosure 61, 62
reflector learning style 45 self-efficacy 85
reflex responses 88 self-esteem 85
reinforcement 81 self-evaluation statement 189
relational self 85 self-fulfilment 85
relationship styles 1634 self-help books 9, 1767
Index 227

self-image 139 taking stock 189


self-object 85 talking about oneself 61
self-promotion 196 Tamasese, Kiwi 192
self puzzle 23, 85 teacher, therapist as 108, 163
self-talk, dysfunctional 90, 98 technological advances 205
self-therapy 47 television 179
self-understanding 62 terminal illness 122, 160
seminars 11 themes, existential 24
sensory awareness inventory 181 theorist learning style 45
separate schools 205 theorists
service design/delivery 205 biographies of 1056
settings 154 imaginary dialogue between 11011
sexual abuse 141, 157 letter to a theorist 114
sexual attraction 25, 116, 160 theory 734
sexual problems 25 applying to ones personal experience 812
sexuality 25, 124 applying in practice 87
Shlien, John 11516 and group learning 55
significant events, of a group 623 integration with practice 8, 205
significant others, letters to 1745 key theoretical ideas 75
skills 27, 190 levels of theorizing 778
Skovholt, Thomas 108, 207 relationship with 76
small groups see learning groups theoretical orientation and moral values
social factors 100 154
social groups 68 therapeutic failure 1834
social status 47 therapeutic relationship 10, 75, 1624
solution-focused therapy 967 creating and maintaining 162
specific techniques 989 issues and challenges 1089
spirituality 43, 79, 85, 205 learning to offer 35
statement of personal philosophy of counselling/ relationship styles 1634
psychotherapy 12 therapist see counsellor/therapist
stimuli 88 therapy room 20, 199
stories 9, 73 therapy thrillers 206
development in ones life 578 thick/thin description 15
favourite 212, 1678 thick story 15
helping relationship 19 Thorne, B. 92, 94
making sense of 1678 timelines 25, 29, 152
origins and development of interest in therapy toolbox, counsellors 1934
20 touching 55, 160, 1656
see also writing trainer see tutor/trainer
strengths-based approach 967, 205 training 2, 3, 189
strengths and weaknesses, identifying 8 accounts of 207
stress 130, 157, 200 narrative approach to personal and professional
work stress 132 development 54, 20913
Strupp, H. 12 stage of and learning group processes
student counselling 1201, 13940, 157, 159, 21213
160 transference 11516
study groups 11 transgressions (boundary violations) 1334, 172
see also learning groups transparency 92
summing up 189 transpersonal relationship 1089
supervision 8, 119, 200 trust 110
support 7, 9, 53, 163 Tuhaka, Flora 192
support network 2001 tutor/trainer
symptoms, physical 1269, 141 learning group facilitation 4, 6, 11, 53, 209
system, group as a 67 notes for 1012
systematic desensitization 98 two-chair dialogues 98
228 Index

unconscious, the 73, 77, 85, 1012 women 109, 194


understanding 103, 116 work stress 132
cultural context of 107 workshops 11
experience of being understood 312 world, image of the 167
framework for 3, 4, 734 worldview, assumptions informing 98
unity of self 85 writing 78, 11
universality 62 autobiographical 17, 24, 812,
21011
values, moral 1524 personal 1516, 48
vicarious experience 47 personal learning journal 56, 7, 11, 18, 56,
voices, hearing 1301 114, 21011
portfolio of 1112
Waldegrave, Charles 192 reflecting on the experience of writing about
websites oneself 489
counsellors website 196 therapeutic nature of 6, 18
as resources 178 see also stories
White, Michael 27
wilderness guide metaphor 108 Yalom, Irvin 62, 194
The
Counsellors John McLeod

Counsellors Workbook
Workbook

The
Developing a Personal Approach
Second Edition
This new edition of The Counsellors Workbook offers you a personal exploration of the key
issues that may emerge during your development as a therapist. It provides you with an
opportunity to document and consolidate your learning and personal development. The
Counsellors Workbook can be used as a stand-alone resource or as a companion text with
either the bestselling text, An Introduction to Counselling 4e or other key sources.
This book will help you to become an effective counsellor or psychotherapist by:
Deepening and consolidating personal learning and development
Facilitating the integration of theory, practice and personal experience
Providing arenas for collaborative dialogue and exploration with fellow trainees
This edition of The Counsellors Workbook has been comprehensively updated to reflect
developments in the field and it now contains over eighty unique exercises.
Other enhancements to the book include:
A helpful introduction to the book so that you understand how to use
The Counsellors Workbook effectively
Learning tasks that cover new topics in An Introduction to Counselling
4e, such as transactional analysis theory
An entirely new section that focuses upon being a member of a learning
group and developing self-awareness
New case studies that illustrate effective counselling in practice
Clear cross-referencing between The Counsellors Workbook and the
relevant passages in An Introduction to Counselling 4e
Updated internet resources and further reading should you wish to
explore subjects further
The

John McLeod
Counsellors
A new appendix that presents a narrative approach to personal and
professional development in counselling and psychotherapy training
The Counsellors Workbook is an invaluable resource for counselling or psychotherapy
students, tutors and trainers, as well as for experienced practitioners engaging in continuing
professional development.

Workbook
John McLeod is Professor of Counselling at the University of Abertay, Dundee, UK. He has
practised in a range of counselling settings, as well as being involved in training, research
and consultancy with many occupational groups, including nurses, doctors, social workers
and emergency services personnel. His many publications include An Introduction to
Counselling 4e and Counselling Skill.
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Edition

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