Stephen Goss

Applied pluralism in the evaluation of employee counselling

Abstract The method and major findings of a complex, ‘pluralist’ evaluation, which investigated the effectiveness of the counselling provision of an employee support and counselling service in a local authority education department over 22 months, are outlined. Reference is made to the underlying philosophical approach of integrated pluralist evaluation, which may represent a significant step forward from the accepted methods of triangulation. In addition to achieving predicted high satisfaction rates from clients, counsellors and clients both indicated significant improvements in all measures used. These were maintained at follow-up which took place at intervals from 1 to 18 months after counselling had ended. Reduction in absenteeism post-counselling suggested the possibility of very substantial revenue savings. Responses also indicated the acute, and often chronic, need for employee counselling provision in the education system.

New Technologies for the Management and Rehabilitation of Chronic Diseases and Conditions

The economic burden of chronic diseases and conditions (such as cardiovascular pathologies, diabetes, obesity, chronic obstructive pulmonary disease, chronic pain, and traumatic brain injuries) requires new solutions not only in traditional clinical settings (in-patient treatments), but also in innovative healthcare scenarios (out-patient long-term monitoring). New technologies can provide clinicians and patients with many solutions at different levels: diagnostic and monitoring, early risk detection, treatment and rehabilitation, provision of feedback and alerts, and motivational strategies that facilitate changes in dysfunctional behaviors or maintenance of healthy lifestyles. A health technology assessment approach is necessary in order to collect evidence to evaluate the clinical and cost effectiveness of new tools and to strengthen the political choice to use health technologies in clinical fields. Telemedicine, e-health, and m-health scenarios can improve health outcomes, quality of life, and well-being and facilitate functional patient empowerment and engagement. Mobile technologies in particular can offer advantageous solutions: m-health could be considered an evolution of e-health and defined as the practice of medicine and public health as supported by mobile communication devices. Indeed, the m-health approach has the potential to overcome many of the limitations associated with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. A range of electronic health systems have been implemented in chronic disease management using stationary and mobile computers, smartphones, and other mobile platforms with differing access to data technology. New innovations in technology are required to meet the challenges associated with overcoming various barriers such as organizational and technological difficulties, lack of technology acceptance, costs of system implementation and maintenance, lack of system interoperability with other informatic tools, reduced communication between clinicians and patients, and difficulties in data processing due to the limitations of devices used in patient monitoring. There is potential for the development of a new and innovative model of healthcare as represented by such technologies as telemedicine, e-health applications, biomedical sensors and devices, integrated platforms and technologies for remote monitoring and management, web and Internet based clinical protocols, and m-health solutions. This model has the potential to offer healthcare that is tailored to the specific needs of the individual, whilst providing the benefits of a mobile, noninvasive, balanced, integrated, and lifestyle friendly framework that is useful from both a preventative and intervention-focused perspective. The major aim of this special issue is to bring to light new international developments in the management and rehabilitation of a range of chronic diseases and clinical conditions, such as stroke, dementia, cardiovascular diseases, dialysis patients, or those with facial paresis. A range of technological developments, lifestyle, and environmental factors have been described in relation to these diseases, including a rehabilitation system for stroke patients using vibrotactile feedback, a new system of facial movement analysis for facial paresis, an exploration of the effects of exercise for dialysis and cancer patients, and the influence of environment on those with dementia and coronary artery disease. In conclusion, as demand for the management of a range of chronic conditions increases in the imminent future, there is likely to be considerable scope for the integration of clinical psychology and medicine. A key future challenge for those working in both traditional and m-health/e-health settings will be to further develop the evidence base for chronic care management in order to enhance technological standards and fine-tune both clinical protocols and organisational models. Gianluca Castelnuovo Giancarlo Mauri Susan Simpson Angela Colantonio Stephen Goss

Symposium on online practice in counselling and guidance

This symposium looks at the impact of the online environment on the practice of guidance, counselling, psychotherapy and related services. Online delivery of careers education and guidance, counselling, psychotherapy and other mental health and social services has been a subject of increasing debate and has regularly featured in the pages of this journal. In 2009, a symposium (Volume 37 (3)) focused on the use of technology in counselling and psychotherapy, and explored the utility of a range of online and telephone technologies. The subsequent six years have seen considerable changes in technologies, their place in society and their role in the practice of guidance and counselling. The current symposium explores these ongoing changes and in places looks forward to ways in which the future development of the disciplines might be influenced by current technological trends. Working through technology of any kind has long provoked highly polarised reactions in many of the human-oriented professions (Goss & Anthony, 2003, p. 1). Commentators have pointed out that despite the hype associated with new technologies the evidence base for their use in guidance and counselling is sometimes limited (Howieson & Semple, 2013; Richards & Viganó, 2013). However, as this symposium demonstrates, it has been growing for a considerable period, and the use of communication technologies is increasingly becoming part of everyday practice in an ever expanding variety of ways (Anthony, Nagel, & Goss, 2010). Some have raised more fundamental concerns about a perceived loss of the human element and reductive conceptions of what guidance and mental health services do. For example, a Guardian article about career guidance asked ‘can online careers advice work ... what about the personal touch?’ (Tickle, 2011), and a succession of reports have found that even the young, and supposedly digitally native (Prensky, 2001), are still crying out for face-toface interactions (Association of College, 2014; Evans & Rallings, 2013). At the other end of the spectrum, advocates of technologically mediated provision talk of how online environments empower clients, democratise practice, allow guidance and therapeutic relationships to transcend time and space, and bring distinct advantages not available in face-to-face settings (Anthony et al., 2010; Goss & Anthony, 2003; Hooley, 2012). Now, however, online provision is blossoming onto the mainstream of practice throughout the helping professions. Some who come across the concept of working at a distance from one’s clients still react with the same polarised views of either strong scepticism or evident, perhaps even incautious, enthusiasm (Hennigan & Goss, 2014; Kettunen, Vuorinen, & Sampson, 2013). It is sometimes tempting, even among those who are otherwise thoroughly experienced senior figures, to think that little work on it has been done and that basic questions need to be addressed from scratch. While there are certainly distinct gaps in the research base, this is far from the case. Research into the use British Journal of Guidance & Counselling, 2015 Vol. 43, No. 1, 1–7, http://dx.doi.org/10.1080/03069885.2015.995471

Counselling and guidance in Africa

The practice of counselling and guidance in Africa may not be very comparable with the way these are practised in the Western world. Reasons for this range from the nature and experiences of the cl...

Interview with Audrey Jung, President of the International Society for Mental Health Online (ISMHO), Presented at the Online Counselling and Therapy in Action Conference, 25 April 2009.

ABSTRACT Counselling services provided online have become an increasingly important topic over the last decade. It is now incumbent on all practitioners at least to be aware of the impact of online living for their clients and of the options available for online counselling provision. In this article, Kate Anthony of the Online Therapy Institute interviews Audrey Jung about her experience as an online counsellor and her views on the needs for, and future development of, practice in this field.

Counsellors' Phenomenological Experiences of Working with Children or Young People who have been Cyberbullied: Using Thematic Analysis of Semi Structured Interviews

There is currently a large body of quantitative evidence to support the prevalence of cyberbullying behaviours, however operationalising the term and measuring this consistently is proving difficult. Aim: The present study aimed to explore qualitatively how counsellors define, understand and work with this issue with clients. Method: Six child counsellors were interviewed about their experiences of working with clients who had been cyberbullied. Analysis: Data was analysed using Braun and Clarkes 2006 thematic analysis. Results: Seven themes emerged with three sub-themes arising from these. Discussion: The research provides a balanced argument for appropriate training and continuing professional development for counsellors and supervisors working with this issue.

Further studies in counselling and guidance in Africa

For the first time in a history that spans more than four decades, the British Journal of Guidance and Counselling is producing a symposium spread across two issues. This is our second special edition focussing primarily on counselling and guidance in Africa. The first part appeared in Volume 42, issue 4, in 2014. This part continues, deepens and expands upon our original intent. We noted in our first editorial (Goss & Adebowale, 2014) that practices in guidance and counselling can – often – differ sharply in Africa from those in the West. Attempts to transfer approaches developed in, say, the USA or UK wholesale are liable to be, at best, only incompletely successful. Neither has the history of counselling and guidance always included serious attempts at adaptation when applying theories and practices developed in one culture to another. There have been plentiful examples of (usually) well-intentioned attempts to implement services or training programmes based almost entirely on largely unadapted modalities developed for Western contexts. It can all too easily seem as though a post-colonialism of the mind (after Thiong’o, 1986) that extends far beyond language into the entire psychosocial, political and relational milieu has remained in place. Cultural difference – even the discussion of it – can all too readily be ignored into silence, sometimes even despite everyone involved wanting to change that (Mavinga-McKenzie, in press). Against that background, metaanalysis of research studies demonstrates noticeable, if moderate, impacts from even very basic cultural adaptation (e.g. Smith, Rodríguez, & Bernal, 2011), such as use of a client’s first language or matching clients and practitioners of similar ethnicity. Accounting for cultural content and values was found to be even more effective, leading to more than 8 tenths of the benefits of cultural adaptation when compared with unaltered practices that have simply been transplanted as if they were so strong as to flourish under any conditions at all. Culturally speaking, conditions not only vary widely but have a profound impact on the ways in which people should set about helping one another, the social systems they may have to call upon and the psychosocial and emotional implications of any given way of interacting. Transporting approaches to counselling and guidance into Africa is one thing. To treat Africa as if it were a single place is another, and an error to which Westerners, including the Editors of journals, can also be prone (Wainaina, 2008, 2014). We repeat, therefore, that we have no intention in these two special editions of this journal to create a body of work that is in any way representative of African counselling and guidance work as awhole, or that typifies it. To do so would, inevitably, invite unhelpful stereotyping (Doh, 2009). Rather, it is our intention to provide a small, and avowedly unrepresentative, sampling of studies that warrant publication in their own right. Almost all come from authors from the locales and cultural contexts of which they write.

Online counselling: a handbook for practitioners

Guidance does, however, and is viewed as an important part of the strategic framework. The entitlements framework includes a range of general entitlements, some transition entitlements, and two ‘infrastructural guarantees’, one of which is ‘universal access to advice and guidance’ (the other is ‘universal access to a minimum level of digital technology’). The report states that this should be ‘holistic, covering a wide range of advice, centred around individuals’ needs and not separating these into unrealistic compartments; so it should address, not only people’s professional learning but also their other concerns’. Special provision should be made at the key transition points around 25, 50 and 75 for voluntary ‘staging-post’ reviews of what part learning might play in the next phase of their lives, linked to the notion of a ‘citizens’ curriculum’ for each phase. This is focused around four broad capabilities: civic, health, financial and digital. In terms of how this is to be delivered, no blueprint is offered. There are welcoming references to the government’s current proposals for its new adult advancement and careers service, which is implicitly seen as playing a pivotal strategic role. There are also references to the notion of a web-based MyFutures Folder, to a wide range of other ‘intermediaries’ (including union learning representatives, hailed as ‘one of the most unambiguously successful initiatives in the recent history of lifelong learning’), and to the concept of Local Learning Exchanges (a possible location for the new service, where people could also pool entitlements and explore ways of exchanging their skills and competences with others). Within these proposals, the concept of ‘career’ plays a limited role. Its significance is that it links learning to progression in work (in its broad sense, extending beyond employment). But this word, too, does not appear in the index, and is mentioned only occasionally. In the discussion of the citizens’ curriculum, there is no mention of career management capabilities (though some are implicitly included under civic capabilities). There is a final section within this chapter on ‘capability and employability’, but it bears signs of being a late insertion (as does the section on ‘improving the quality of work’ in the closing chapter). A stronger positioning of work and career in relation to learning would have enhanced the report and, perhaps, its potential political impact. It remains, however, a significant achievement: a humane, well-argued contribution to political debates, marshalling a wide range of evidence with skill and clarity, and carefully avoiding hyperbole to support its case.