Richard House

The be-coming of a therapist: experiential learning, self-education and the personal/professional nexus

ABSTRACT Grounded in a narrative account of the authors own development as a counselling practitioner, it is argued that a programmatic developmental path for therapy practitioners can be singularly inappropriate. Such a route to practitionerhood threatens to interfere with, and even fundamentally to undermine, the necessarily unique idiosyncrasies of practitioner development, and the often ineffable, unspecifiable nature of the therapeutic process itself. Some tensions lying at the heart of the attempt to professionalise the therapy field in Britain are articulated in this personal chronicled history of principled challenge to statutory regulation. The Independent Practitioners Network is introduced as an approach to accountability that strives to avoid many of the worst incoherencies of the ‘modernist’ bureaucratic institution, and suggestions are made as to how we might enable diverse, innovative practitioner development in Late Modernity.

Reconceptualizing early childhood care and education: critical questions, new imaginaries and social activism: a reader

is in this and the next chapter that Taylor’s work becomes so rich and challenging as she walks the reader through two Australian children’s stories which offer new insights to how children and nature might relate through an ethic of the other (Levinas 1969) and develop a ‘common world’. The ‘common world’ is taken further in the final chapter – ‘Enacting Common Worlds’ – through discussion of the ways that Australian groups such as the central Arrernte people and the Yipirinye educate children to be part of nature. For me, the most exciting discussion was of an installation by Piccinini (2012) entitled ‘Undivided’: a ‘hyperrealist figurate silicon sculptural installation’ (109) which shows a human child curled up asleep with a ‘sci-fi, non-human, but strangely humanoid’ (109) creature curled up round her. The installation, argues Taylor, alerts us to the ways that ‘technocultural and ecological dilemmas’ are intertwined (111). This is a rich book which provides a great deal of food for thought. The compact writing draws the reader into engagement with the multiple layers of Taylor’s argument and points to new ways of thinking about how we might educate children to be part of the natural world and reflect on their interactions with it. It is a book which all of us working with children should read.

Training and education for therapeutic practitionership: “Trans-modern” perspectives

In this paper I revisit the theme of therapy training, examined in this journal a decade ago in House (1996. I first outline what I mean by the term “trans-modern” in the context of debates about “postmodern” and deconstructive approaches to therapy. I then explore the configuration that therapy training might plausibly take when technological rationalitys positivistic certainties are dramatically undermined, and the path to becoming a therapy practitioner coheres more closely with the trans-modern, “New Paradigm” Zeitgeist–a world-view which both acknowledges the (albeit unbalanced) contributions of modernity, yet takes us well beyond modernitys constraining limitations. To illustrate my argument I focus on and problematize the role of theory in therapy training. I conclude with some speculations about plausible paths that a trans-modern approach to therapy training might profitably take in future.

Beyond postmodernism: New dimensions in clinical theory and practice

The term ‘postmodernism’ (or the ‘P word’, as Roger Lowe has called it – Lowe, 1999, p. 73) is a rather malleable, loosely-defined term which often triggers strong emotional reactions, and which can serve to obscure far more than it illuminates; and for this reason, some have suggested that we replace the term with less emotive ones, such as ‘a generalized climate of problematization’ (Lowe, 1999, p. 73), and with philosopher Richard Rorty going as far as concluding that ‘The term [postmodernism] has been so overused that it is causing more trouble than it is worth’ (Rorty, 1991, p. 1). The ‘postmodern turn’ in psychoanalysis, psychotherapy and psychology (Faulconer & Williams, 1990; House, 2003; Kvale, 1992) has been prompted by a profound epistemological and political disillusionment with the psyche profession’s perceived capture by the ideology of modernity, with its accompanying belief in

General practice counselling amidst the ‘audit culture’: History, dynamics and subversion of/in the hypermodern National Health Service

This paper takes an explicitly political perspective in examining some of the key arguments which General Practice (GP) counsellors, struggling to make sense of working in a milieu that contradicts their value system, are currently needing to address. Beginning with a brief contextualising of the ‘audit culture’ as a ‘hypermodern’ cultural phenomenon, challenges to the authors previous published writings on GP counselling are then invoked to open up key arguments that are confronting GP counsellors in their work. It is argued that there are major difficulties of values-incongruence for any non-Cognitive Behaviour Therapy (CBT) counsellor now working in an NHS GP milieu, and that for practitioners to find an authentic-enough stance for their client work, resistance, subversion and even organised principled non-compliance might be a necessity for practitioners wishing to stay true-enough to their core beliefs and professional identity. The nature of the National Health Service’s (NHS) current attitude to the psychological therapies could mean that practitioners have to make the stark choice between incongruent compliance, values-congruent subversion, or outright rejection of what they are asked to do (with resignation or even redundancy being one possible outcome). A variety of strategies will no doubt be pursued by different practitioners at different times, and the courage that practitioners are able to garner in this paradigmatic struggle for the ‘soul’ of our work can contribute towards a longer-term, much-needed sea-change in the states attitude to counselling and psychotherapy as modern healing practices.

Effective short-term counselling within the primary care setting: psychodynamic and cognitive-behavioural therapy approaches

What I particularly like about this new book on General Practice (GP) counselling by Valerie Garrett is that it is squarely a book for the thoughtful practitioner. It does not avoid theory, but it manages to render it in a pleasingly digestible and manageable way. It is also full of wisdom. The author comes across strongly as a practitioner with immense experience of GP settings, who brings an informed, common-sense approach to GP counselling from which anyone working in such settings, from newly practising placement trainees to experienced counsellors, can learn a great deal. When I first started practising as a counsellor in 1990, general practice counselling was all the rage, and continued to be so for at least a decade. Now, two retrospective decades on, those seem like halcyon days indeed the high-water mark, perhaps, of counselling in medical settings, when counsellors were often able to do long-term work when clients needed a longer-term intervention, and were relatively free of the obsessive, anxiety-driven ‘audit culture’ which now so dominates the public services, and from which the psychological therapies have, alas, been far from spared (King & Moutsou, 2010). With the hegemonic rise of Cognitive Behaviour Therapy (CBT), the Improving Access to the Psychological Therapies (IAPT) system and the National Institute for Health and Clinical Excellence (NICE) guidelines, the clinical freedoms that counsellors previously enjoyed in primary care settings are now in somewhat abject retreat, if not having all but disappeared. However, in this age of single-minded standardisation, it is gratifying that there does still exist a great deal of diversity in general practice, with some counsellors still managing to find ways of working creatively and effectively, in spite of the new programmatic managerial strictures and structures. One way of responding to this situation has been for experienced GP counsellors to do some further training, effectively ‘re-branding’ themselves as CBT counsellors or perhaps more accurately, counsellors trained in CBT who are able to draw upon CBT practices in response to particular patient needs. A recent ‘straw poll’ at the Counsellors in Primary Care annual conference in May 2011 certainly showed that the vast majority of GP counsellors present had indeed done some further ‘bolt-on’ British Journal of Guidance & Counselling, Vol. 40, No. 1, February 2012, 99 110

Understanding behaviour and development in early childhood: a guide to theory and practice

strate that children are alert and sensitive readers, actively working to make increasingly nuanced sense of the images and stories they encounter. It shows how children use adults, as more experienced learners, to assist them in their construction of understandings and responses to what they encounter. The book, though 242 pages long, actually consists of only 139 pages of argument. The remaining pages are an appendix of the raw data, together with bibliography and index. Although written with great enthusiasm, the book suffers from a weak organisation of ideas. It might have been better to offer the reader, at the start of the book, some contextualising strands of theory against which the data might be iterated. As it is, there are references to literature and concepts scattered through the chapters, which, although intended to support her findings, often feel rather clumsily woven into discussion. Many references felt as though they had been dropped in to show a breadth of reading rather than to support an argument – references to Goya (p. 33) and Atwood (p. 43) were two particularly grating examples of this. I felt that the rich data gathered were underexplored and often minimally discussed, with a sense of res ipsa loquitur, which, sadly, they did not. I wondered, too, how valid some of Toomey’s claims were: often she seemed to make assertions without fully sustaining a reliable argument for them. Ultimately, I felt that her claims to reliability were seriously undermined by a descriptive narrative of the data; unreferenced assertion; failure to explore alternative understandings of the data; and an apparent desire to make the data fit her argument. The conclusion is more fluid and nuanced than the rest of the book: it raises questions and issues that those involved in English education need to consider carefully, if for no other reason than to guide them away from prescriptive book lists. Overall, this is an interesting and worthwhile study which might benefit from a more nuanced exploration in the context of, rather than being made to match, the literature. I found myself frequently wanting to challenge interpretations of the presented data and to seek alternative interpretations. Nevertheless, the book is an interesting contribution to the field of early literacy development, and to understandings of what kinds of sense young children make of their interactions with others, both fictional and real.

The human being fully alive: writings in celebration of Brian Thorne

Kaleidoscope Career Model (Sullivan). Contextual approaches are well represented in this book, with consideration given to how the self is likely to develop in the context of gender (Heppner and Fu), cultural formulation (Leong, Hardin, and Gupta), and social class (Blustein et al.). Blustein has sought to formulate an inclusive theory of working, aiming to accommodate those individuals who, by dint of what can be referred to as their existential position of ‘thrownness’ or ‘being in the world’ (Heidegger, 1962), are denied the luxury of ‘occupational choice’. The chapter on cultural formulation highlights the need for counsellors’ multicultural sensitivity, being aware that an intervention technique such as confrontation is counterproductive with clients hailing from a collectivist tradition. The authors apply the Cultural Formulation Approach in an intriguing case of Yong Lee, an 18year-old, single, gay Chinese American, whose counsellor is challenged to help him confront a plethora of multi-cultural conflicts. Some of the chapters offer additional vignettes of illustrative career counselling cases as well as demonstrating how assessment tools can harness the client’s ‘self ’, but the book’s strength lies elsewhere, in updating theoretical approaches in the context of ‘self ’. Developing Self in Work and Career enables the reader to reassess many traditional and modern theoretical formulations. Many of the chapters present overlapping if not redundant concepts via different lexicons, often producing a déjà vu effect. Indeed the editors anticipate that, in light of socio-economic changes, the fields of vocational psychology and career counselling will be shifting their focus from studying career development to investigating how people make meaning through work and career. They foresee the ‘self ’ as occupying a critical role as a unifying construct, linking fields in the social and behavioural sciences. This book deserves a place of honour in the career development literature, perhaps sharing a shelf with a theoretical predecessor, Convergence in Career Development Theories (Savickas & Lent, 1994), another valiant effort aimed at identifying commonalities in vocational theories. In fact, the two volumes have several common contributors.

Welcome to the ‘Paradigm War’: the case of antidepressant medication

The number of antidepressants prescribed by the [UK] NHS has almost doubled in the last decade, and rose sharply last year as the recession bit, figures reveal. The health service issued 39.1m prescriptions for drugs to tackle depression in England in 2009, compared with 20.1m in 1999 – a 95% jump. Doctors handed out 3.18m more prescriptions last year than in 2008, almost twice the annual rise seen in preceding years, according to previously unpublished statistics released by the NHS’s Business Services Authority. The increase is thought to be due in part to improved diagnosis, reduced stigma around mental ill-health and rising worries about jobs and finances triggered by the economic downturn. (Davis, 2010)

Committed uncertainty in psychotherapy: Essays in honour of Peter Lomas, edited by Lucy King

It is . . . appallingly difficult to communicate usefully about therapy; first because there is no generally acceptable definition of health (and therefore of cure); and, secondly, because those who are anxious to bring about a beneficial change in people’s lives are, through human frailty, liable to overvalue their method and results . . . . The need now . . . is to demystify the practice of psychotherapy and to recognise that the experiences within it are not only part of the natural world but can be encompassed by our ordinary capacities for experience . . . .