Mick Cooper

A pluralistic framework for counselling and psychotherapy: Implications for research

Abstract Historically, training, research and practice in counselling and psychotherapy have been dominated by unitary theoretical models. Although integrative and eclectic positions have been developed as alternatives, these have not been successful in generating research and have resulted in a further proliferation of competing models. In this paper we introduce a ‘pluralistic’ framework for counselling and psychotherapy and discuss the implications of this framework for research. The basic principle of this pluralistic framework is that psychological difficulties may have multiple causes and that there is unlikely to be one, ‘right’ therapeutic method that will be appropriate in all situations—different people are helped by different processes at different times. This pluralistic framework operates as a meta-theory within which it is possible to utilise concepts, strategies and specific interventions from a range of therapeutic orientations. The framework is structured around three domains—goals, task ...

Counselling in UK secondary schools: A comprehensive review of audit and evaluation data

Abstract Aims: The purpose of this study was to develop a comprehensive picture of the nature and outcomes of counselling in secondary schools in the UK. Method: Audit and evaluation studies of schools counselling were identified using a systematic literature search. Thirty studies were found and analysed using a variety of methods. Typically, counselling services provided purely person-centred, or person-centred-based, forms of therapy. Results: Averaged across all studies, clients had a mean age of 13.86 and attended for 6.35 sessions of counselling. The average percentage of female clients per study was 56.31%. Most frequently, clients presented with family issues, with anger issues particularly prevalent in males. Around 60% of clients began counselling with ‘abnormal’ or borderline levels of psychological distress. Counselling was associated with large improvements in mental health (mean weighted effect size = 0.81), with around 50% of clinically distressed clients demonstrating clinical improvement....

The Young Person's CORE: Development of a brief outcome measure for young people

Abstract Background: There is a need for a user-friendly measure of change for use in school and youth counselling services which is easy for practitioners to administer and score, and which is appropriate for brief interventions. Aims: To develop such a measure and to present psychometric data on reliability, validity and sensitivity to change for the measure. Method: We employed a three-stage approach: first, creating a pool of potential items; second, developing an 18-item version; and third, refining to a final version comprising 10 items. We called the measure the Young Persons CORE (YP-CORE). Results: The measure comprised eight negative and two positive items and included a single (negatively-framed) risk-to-self item. Psychometric properties were all acceptable. Sensitivity to change was good and yielded an average improvement of 10 points on the YP-CORE in a clinical group, broadly equivalent to changes in adult versions (e.g. Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM))....

THERAPISTS' EXPERIENCES OF RELATIONAL DEPTH: A QUALITATIVE INTERVIEW STUDY

Abstract The aim of this study was to explore therapists’ experiences of meeting their clients at a level of ‘relational depth’. This was defined as a feeling of profound contact and engagement with another, in which the therapists experienced high levels of empathy, acceptance and transparency towards their clients, and experienced their clients as acknowledging their empathy and acceptance in a genuine way. Participants were primarily experienced person-centred therapists, five of whom were female and three of whom were male. Data was gathered through the use of qualitative, unstructured interviews within the broader framework of a person-centred and phenomenological methodology. All interviewees described experiencing moments of relational depth with their clients, and substantial commonalities emerged in their descriptions. These included heightened feelings of empathy, acceptance and receptivity towards their clients; powerful feelings of immersion in the therapeutic work; increased perceptual clarit...

Existential therapies: a meta-analysis of their effects on psychological outcomes.

OBJECTIVE To review the evidence on the efficacy of different types of existential therapies: a family of psychological interventions that draw on themes from existential philosophy to help clients address such issues in their lives as meaning and death anxiety. METHOD Relevant electronic databases, journals, and reference lists were searched for eligible studies. Effects on meaning, psychopathology (anxiety and depression), self-efficacy, and physical well-being were extracted from each publication or obtained directly from its authors. All types of existential therapy for adult samples were included. Weighted pooled mean effects were calculated and analyses performed assuming fixed-effects model. RESULTS Twenty-one eligible randomized controlled trials of existential therapy were found, from which 15 studies with unique data were included, comprising a total of 1,792 participants. Meaning therapies (n = 6 studies) showed large effects on positive meaning in life immediately postintervention (d = 0.65) and at follow-up (d = 0.57), and had moderate effects on psychopathology (d = 0.47) and self-efficacy (d = 0.48) at postintervention; they did not have significant effects on self-reported physical well-being (n = 1 study). Supportive-expressive therapy (n = 5) had small effects at posttreatment and follow-up on psychopathology (d = 0.20, 0.18, respectively); effects on self-efficacy and self-reported physical well-being were not significant (n = 1 and n = 4, respectively). Experiential-existential (n = 2) and cognitive-existential therapies (n = 1) had no significant effects. CONCLUSION Despite the small number and low quality of studies, some existential therapies appear beneficial for certain populations. We found particular support for structured interventions incorporating psychoeducation, exercises, and discussing meaning in life directly and positively with physically ill patients. It is important to study more precisely which existential intervention works the best for which individual client.

Dialogue: Bridging Personal, Community, and Social Transformation

The concept and practice of dialogue has underpinned key developments in humanistic psychotherapy and counseling. However, dialogue has also been adopted by, and incorporated into, a range of educational, community and social theories and practices, and in this sense forms a valuable bridge between humanistic psychology and the wider field of sociopolitical theory and activity. This article critically reviews how the concept of dialogue has been developed and applied in four key domains, each oriented around the work of a principal theorist: psychotherapy (Martin Buber), education (Mikhail Bakhtin), community development (Paulo Freire), and social transformation (Jürgen Habermas). Drawing this analysis together, the discussion identifies three principal ways in which the term dialogue has been used: transformative, ontological, and everyday; outlines the different levels at which dialogue can take place; and identifies key questions for further exploration.The concept and practice of dialogue has underpinned key developments in humanistic psychotherapy and counseling. However, dialogue has also been adopted by, and incorporated into, a range of educational, community and social theories and practices, and in this sense forms a valuable bridge between humanistic psychology and the wider field of sociopolitical theory and activity. This article critically reviews how the concept of dialogue has been developed and applied in four key domains, each oriented around the work of a principal theorist: psychotherapy (Martin Buber), education (Mikhail Bakhtin), community development (Paulo Freire), and social transformation (Jurgen Habermas). Drawing this analysis together, the discussion identifies three principal ways in which the term dialogue has been used: transformative, ontological, and everyday; outlines the different levels at which dialogue can take place; and identifies key questions for further exploration.

Scottish secondary school teachers’ attitudes towards, and conceptualisations of, counselling

This paper presents the findings of two independent questionnaire studies that examined Scottish secondary schools teachers’ attitudes towards, and conceptualisation of, school counselling. Seventy-one teachers in a first study, and 33 teachers in a second study, responded to a range of qualitative and quantitative response-format questions that were designed to elicit their feelings and attitudes towards school counselling, and their notions of what counselling was. Results from the two studies confirm previous findings in this area, suggesting that teachers are generally positive in their attitudes towards counselling; valuing, in particular, the independence and expertise of the counsellor. A small minority of teachers, however, were found to hold strongly negative views towards counselling. Teachers also expressed concerns that students might abuse the counselling service, and that the service might not fully integrate with existing guidance arrangements provided by teachers in schools. The study also found that a high proportion of teachers conceptualised counselling in terms of advice-giving.

Towards a relationally-orientated approach to therapy: empirical support and analysis

Drawing on contemporary evidence in the counselling and psychotherapy research field, this paper argues that there is growing support for a relationship-orientated approach to therapeutic practice. The paper reviews findings from a range of meta-analytical and individual studies which provide strong evidence for the centrality of relational factors to the successfulness of therapy, and then goes on to examine the specific variables that appear to be linked to positive therapeutic change. Having considered some of the empirical evidence that challenges this position and highlighted the importance of individual differences, the paper concludes by arguing that we need to develop and expand our understanding of the kind of relational factors and processes that most facilitate therapeutic change.

School-based humanistic counseling for psychological distress in young people: Pilot randomized controlled trial

Abstract School-based humanistic counseling (SBHC) is a widely delivered intervention for psychological distress in young people, particularly in the UK. This study piloted a set of procedures for evaluating SBHC and obtaining indications of effect. Psychologically distressed young people (aged 13–16) were randomized to either 12 weeks of SBHC or a waiting list control. The primary outcome was psychological distress at the 12-week endpoint, as measured by the Young Persons CORE. Those allocated to counseling (n=16) showed significantly greater reductions in psychological distress than participants in the control group (n=17), with an effect size (ES) (g) of 1.14 on the primary outcome and a mean ES across all four outcome measures of 0.73 at endpoint. The findings indicate that SBHC may be an effective means of reducing psychological distress in young people.

A state of readiness: an exploration of the client's role in meeting at relational depth

It is widely acknowledged that the therapeutic relationship is important to therapeutic outcome. In recent years, there has been additional evidence to suggest that specific, identifiable moments of relational depth between client and therapist can also have a major positive impact on the progress and outcome of therapy; however, the question of how such moments occur remains largely unexplored. Are they solely initiated by the therapist, or does the client have a role too? This article explores clients’ perceptions of the factors facilitating an experience of relational depth. Findings suggest that immediately prior to such an experience the clients themselves have reached a state of readiness, and as making a positive decision to bring their vulnerability to the fore in the therapeutic relationship, thereby facilitating a potential moment of change. Findings are discussed in relation to contemporary theory with implications for practice given.