As Russel Ayling published his blog post on branding last week I was experiencing some of the issues he speaks about in situ. I was trying to explain to a friend newly embarking on her clinical training what it is that counselling psychologists actually do. The conversation had come about when she told me that a previous colleague of hers had said he had never met a CoP who could clearly explain what they did.
My initial response to this statement was anger. However, I then proceeded to spend the next 10 minutes waffling to my friend in an attempt to succinctly explain the CoP practice. I grudgingly realised that had this chap been speaking to me, he would have had a point. Afterwards it dawned on me that perhaps I find our work so hard to describe because it is so complex. In a nutshell we could say that we are “psychologists who specialise in the therapeutic encounter”. Then again, as highlighted in Russel’s blog and by those who wrote responses to it, other practitioners could say that too.
We know that it is important for us to be able to communicate what it is that we do. Others have published their understandings and in my opinion, an excellent example is Martin Milton’s (2010) book “Therapy and Beyond”. For my personal peace of mind I felt like I needed to compile my own succinct list. I wanted something I could direct people to so that when again in a situation where somebody says “so what does a counselling psychologist do” I can say “well it is rather complex. Why don’t you take a look at this blog”. Thus, heavily influenced by Milton (2010) and those who contributed to the book, the following details what I have come to understand as the CoP way.
(Disclaimer! As highlighted by Russel, it is often hard to work out the difference between our work and the work of those who have undergone clinical training. Indeed, it seems to me that in practice we share much of what we do with many other practitioners. The following is therefore not a case of “we do this and no-one else does”, rather a pulling together of what it is that we do do, regardless of other professions).
1. We are pluralistic at heart.
In light of the pluralistic philosophy, the idea that no superior truth exists, the CoP is known to work flexibly, moulding their approach to the client in-front of them. In my mind this connects to Rogers’ (1957) work and begets the question, what is necessary and sufficient for change in this situation? What do we need to provide for this person in order for them to move forward?
2. We focus on building the relationship.
It has long been established that the quality of relationship between therapist and client is particularly influential upon client outcome (e.g. Lambert and Simon, 2008). The factors which embody a quality relationship are far beyond the scope of this humble blog post however. It may be useful to note that literature suggests there are some commonalities across models (e.g. empathy) and also possible divergences (e.g. strict time boundaries). One poignant paper to consider might again be Rogers (1957) who details what he believed a quality therapeutic relationship would look like.
3. We use the relationship to effect change.
How the therapist uses the relationship to effect change is again a volume within itself. Perhaps this is where the CoPs’ focus on process occurs as we use what is happening between ourselves and our client to what we hope is the client’s best advantage. Practitioners using different models appear to use process in different ways or under different conceptual frameworks. For example, the person-centred therapist might utilise process identification and direction to help the client find answers for themselves (see Rennie, 1998). The psychodynamic practitioner might harness transference interpretations, asking how what is going on in the therapy room might be representative of the client’s patterns in the outside world, and thus making the unconscious conscious (Jacobs, 2010).
We can see here why reflection, often in the form of personal therapy, is important as in using process we are not just analysing the client but ourselves and our contribution to the relationship also.
4. We pay homage to context, and navigate this in the therapy room.
Context can refer to any part of the backdrop to what is happening between one and one’s client. In a sense, context is the elephant in the room. It can refer to economics, race-relations, the legal system, feminism, etc. As CoPs we work with these discourses. For example, perhaps we work at a more surface level with a traumatised client if our service only offers 6 sessions, and then refer them on for longer-term work. Perhaps we spend time explaining to a client looking for a quick fix that therapy isn’t the talking equivalent of a pill.
5. We use research to inform our practice.
Point number 5 is what it says on the tin really. As CoPs we are not just clinicians but researchers also. We (hopefully) keep up-to-date with the latest research and use this to guide our sessions. We ask ourselves, what do we know about mechanisms of change generally? What has been found to elicit change for those with similar demographics to our client? How have others with similar problems been known to recover?
As mentioned earlier, I believe our profession is complex, multifaceted, and difficult to describe. The above is a crude shortening of the nuances of what we do. I guess to do justice to our profession like Milton (2010), I’d need the space of a book. However, writing the above has helped me translate my practice into ‘not so many’ words, and I hope will be useful for others also.
Jacobs, M. (2010). Psychodynamic counselling in action (Fourth ed.). London: Sage.
Lambert, M. J., & Simon, W. (2008). The therapeutic relationship: Central and essential in psychotherapy outcome. In S. F. Hick, & T. Bien (Eds.), Mindfulness and the therapeutic relationship (pp. 19-33). United States of America: The Guilford Press.
Milton, M. (Ed.). (2010). Therapy and beyond: Counselling psychology contributions to therapeutic and social issues (First ed.). United Kingdom: John Wiley & Sons.
Rennie, D. L. (1998). Process identification and process direction. In D. L. Rennie (Ed.), Person-centred counselling: An experiential approach (pp. 71-88).
Rogers, C. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95-103.
Our guest writer Emily Brookes is a final year trainee counselling psychologist. Do feel free to check out our website for details of our clinical supervision register!