Robinder P. Bedi

Critical Incidents in the Formation of the Therapeutic Alliance from the Client's Perspective.

The purpose of this study was to identify and categorize the variables that clients consider important for forming and strengthening a positive therapeutic alliance. Forty participants were interviewed using the critical incident technique and asked to describe observable behaviors and verbalization

Counsellor behaviours that predict therapeutic alliance: From the client's perspective

The therapeutic alliance has been shown to be a robust predictor of counselling outcome. However, the specific counsellor behaviours that relate to the alliance have not been clearly and consistently identified, and prior attempts to identify these variables have not been typically based on client-derived conceptualizations of the alliance. A total of 79 adult counselling clients participated in a study examining the relationship between 15 client-identified counsellor behaviours and the strength of the therapeutic alliance. Correlational analyses revealed that 11 of the 15 behaviours moderately to strongly correlated with the strength of the alliance, and hierarchical regression analyses found that three particular counsellor behaviours (making encouraging statements, making positive comments about the client, and greeting the client with a smile) accounted for 62% of the variance in alliance scores. The findings suggest that seemingly small, strengths-fostering counsellor micro-behaviours can play a key role in strengthening therapeutic alliances. Given the role that alliance plays in positive counselling outcomes, it is suggested that these behaviours be tactfully implemented early on in the counselling process.

What a man wants: the male perspective on therapeutic alliance formation.

Although the link between client ratings of therapeutic alliance quality and psychotherapy outcome has been well established by previous research, there is still much to be done to clarify what variables are important to clients, particularly men, in the formation of an alliance. Thirty-seven male clients currently undergoing psychotherapy categorized 74 critical incidents for alliance formation in an open-ended manner on the basis of self-perceived relatedness. Multivariate concept-mapping statistical techniques were used to identify the typical way in which the participants conceptualized variables that are important to alliance formation. Nine categories of variables were identified (Bringing out the Issues, Nonverbal Psychotherapist Actions, Emotional Support, Formal Respect, Practical Help, Office Environment, Information, Client Responsibility, and Choice of Professional). Bringing out the Issues emerged as the highest rated and most consistently understood category across the men in this study. The results of this study add to a small but growing body of research on the clients perspective of alliance formation and provide an initial conceptual model of how men understand the variables of common alliance formation. The developed model also provides several hypotheses, which are presented for verification in future research and clinical practice.

A global portrait of counselling psychologists’ characteristics, perspectives, and professional behaviors

Counseling psychologists in eight countries (Australia, Canada, New Zealand, South Africa, South Korea, Taiwan, the United Kingdom, and the United States) responded to survey questions that focused on their demographics as well as their professional identities, roles, settings, and activities. As well, they were asked about satisfaction with the specialty and the extent to which they endorsed 10 core counseling psychology values. This article reports those results, focusing both on areas in which there were between-country similarities as well as on those for which there were differences. These data provide a snapshot of counseling psychology globally and establish a foundation for the other articles in this special issue of the journal.

Depression: an inability to adapt to one's perceived life distress?

A comprehensive biopsychosocial distress adaptation model of depression in which neurochemical shortages are awarded a necessary but insufficient status is proposed. In context of this model, depression is seen as a function of inadequate behavioural, psychological, socioenvironmental and biological coping resources (all of which may be partly a function of genetic factors) for managing ones individually appraised level of life distress. It is further hypothesized that the physiological symptoms of depression arise as a result of a lack of available neurotransmitters to contend with stressors as well as maintain the normal functioning of the individual. Unlike many other theories, this distress adaptation model may account for several of the demographics of depression.

Client as expert: A Delphi poll of clients’ subjective experience of therapeutic alliance formation variables

This study extends prior research that identified client-derived variables believed to contribute to therapeutic alliance development. Forty-two clients participated in a three-round-modified Delphi poll in which the subjective importance of 74 client-derived, common alliance formation variables was rated using a six-point scale. Participants consensually identified 23 variables as highly important, five as moderately important and three as low in importance to the formation of a strong alliance. Variables related to validation and asking about parts of the client’s life other than the presenting concern were considered as most important by at least one-third of the sample. Limitations of the study are presented and implications for theory, measurement, practice and future research are briefly discussed.

Counselling Psychology in Canada

Counselling psychology in Canada has experienced tremendous growth and greater recognition within the last 30 years. However, there is little empirical research on the practice of counselling psychology in Canada and the characteristics of Canadian counselling psychologists. We administered a 74 item questionnaire to 79 counselling psychologists who were members of the Counselling Psychology Section of the Canadian Psychological Association, achieving a 35.4% response rate. The survey asked various questions organized under the headings of: Background Information, Theoretical Orientations, Professional Activities, Training and Career Experiences, and Future. Overall, these Canadian counselling psychologists seem to see the discipline as moderately different from clinical psychology and from counsellor education, and are largely satisfied with their choice of career in counselling psychology. Results further indicate that independent practice is the most common work-setting and that respondents spend a large share of their time providing individual, non-career related, counselling/psychotherapy of primarily a rehabilitative/treatment-oriented nature. A strengths-focused approach was also highly valued by the sample. The development of the field, distinctive characteristics of Canadian counselling psychology, the place of counselling psychology in the Canadian health care delivery system, credentialing, professional organizations, education and training issues, allied professions, opportunities for the field, and threats to the field are also discussed.

The future of Canadian counselling psychology: Doctoral students

Little is known about the overall characteristics and beliefs of Canadian counselling psychology doctoral students. An online survey was administered to 43 doctoral students across all Canadian counselling psychology programmes, representing an approximate 26% response rate. Results indicated that the average age of doctoral students in the sample was about 32 years and that the majority were women (about 77% in the sample). Additionally, findings can be taken to suggest that participants were satisfied with their choice of counselling psychology as a career. The doctoral students sampled primarily practised from an integrationist theoretical standpoint and spent very little of their practice time providing formal psychological assessment services or career counselling. Participants generally intervened through individual counselling or psychotherapy and were focused on disorder treatment rather than preventative or developmental services. Curriculum changes that should be considered from the results of this study pertain to the topics of assessment, career counselling, advocacy/media skills, professional identity development and prevention/developmental interventions. The results of this study can also be taken to predict characteristics of the next generation of Canadian counselling psychologists and the future practice of counselling psychology in Canada.

Survey of counselling psychologists in India

Abstract The purpose of this study was to investigate the practice of counselling psychology and the characteristics of counselling psychologists in India in order to address the lack of empirical research on this population. Sixty-five participants, who self-identified as counselling psychologists, were recruited from various parts of India and administered a 56-item survey. Results showed our participants to be comprised of a relatively new and largely inexperienced workforce with inconsistent levels and types of specialty training in counselling psychology. The vast majority of sampled Indian counselling psychologists practiced without a license. Most focused on treatment using individual counselling as their preferred treatment modality and noted career counselling as central to the profession. Participants reported a dire need for programme accreditation and unified licensure for counselling psychologists. They further cited a lack of practical training and limited public awareness as current challenges for the field in India. Comparisons between counselling psychology in India and other countries were made to better contextualize the results and differentiate the field in India.

Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome are inevitable but eliminating global mental health disparities with indigenous healing is not.

The professional practices of counseling and psychotherapy were developed in the Western world to address problems common in Western countries in a manner consistent with Western understandings. There is a small but growing awareness that (a) counseling and psychotherapy are cultural by-products rather than universal healing practices, and (b) counseling and psychotherapy share important therapeutic elements with many well-established indigenous healing practices from other countries. Despite these notions, counseling and psychotherapy are being exported to other countries at a high rate and often without enough scrutiny. Although this is generally done with good intentions to promote global mental health and to address differences in mental health across the world, these practices can be inconsistent with the societal values and collective beliefs of individuals in non-Western countries and can sometimes lead to more harm than good. Providing counseling and psychotherapy to such individuals would be equivalent to offering a westernized individual an indigenous healing practice from a different part of the world that does not fit within a Western belief structure. Therefore, counseling and psychotherapy may not be as effective as long-standing indigenous healing practices for individuals who do not subscribe to the assumptions, customs, cultural principles, and culturally promoted objectives that underlie the Western practices of counseling and psychotherapy. Therefore, these practices should not be always recommended in non-Western cultures. Instead, promoting traditional healers and indigenous healing practices and integrating them with culturally adapted counseling and psychotherapy is recommended to reduce international mental health disparities. S C I E N T I F I C A B S T R A C T Racial, ethnic, cultural, and national disparities in counseling and psychotherapy outcome exist. Greater awareness of this has resulted in many national and international initiatives, often framed in terms of moral responsibility or social justice, intended to eliminate these disparities. Such efforts include well-meant and sometimes effective attempts to culturally adapt counseling and psychotherapy. These efforts carry the implicit assumption that counseling and psychotherapy are scientifically sound, universal treatment practices with worldwide applicability that transcend national and cultural boundaries. However, according to the contextual model, individuals who are living in non-Western countries and those who are living in Western countries but are less acculturated to dominant Western norms may find the practices of counseling and psychotherapy, even when culturally adapted, to be culturally incongruent. The efficacy of these therapeutic practices is constrained by the extent to which individuals subscribe to the cultural meanings and moral visions underlying the Western institutions of counseling and psychotherapy. To the extent that they do not is the extent to which counseling and psychotherapy are not appropriate treatment strategies and to which such individuals would benefit from an alternative approach more in line with their cultural conditioning. In other words, these individuals may be no more likely to benefit from counseling or psychotherapy than a Western individual would be to benefit from a non-Western indigenous mental healing practice. Therefore, the best way to reduce mental health disparities globally is to promote indigenous healing practices in isolation and in collaboration with culturally adapted counseling and psychotherapy.