Counselling psychology

Question 1

How do counselling and therapeutic counselling differ?

Answer 1

Counselling refers more to advice on aspects of everyday life e.g. marital counselling
Therapeutic counselling involves working closely with individuals and their relationships, maybe in the form of crisis support or psychotherapeutic guiding, helping individuals to find their own coping mechanisms and problem solving methods for maladaptive behaviours

Question 2

What is the role of a counsellor/psychotherapist?

Answer 2

Help people talk about feelings, and think about choices/behaviour, to bring about positive change

Question 3

What are some key differences between counsellors and psychotherapists?

Answer 3

Psychotherapists are professional practitioners in hospitals, more concerned with severe psychological disorders and patients are often dependent on them to gain control over thoughts and emotions
Counsellors can work in voluntary agencies and can be non-professional, dealing mainly with everyday problems; counsellors will have Health and Care professions council approved training but psychotherapists are more highly trained and have specialisms not necessarily in a psychology background
Some “therapists” will have very little training

Question 4

What are 4 specific differences between counselling and psychotherapy?

Answer 4

Counselling is short term while psychotherapy is generally longer term
Counselling aims to support a patient to perform everyday activities in a normal and efficient manner while psychotherapy uncovers underlying foundations of a problem and addresses them
Counselling addresses issues in a less in-depth manner than psychotherapy
Counselling mainly deals with patients who are fit enough to think rationally and find solutions to own problems

Question 5

Define counselling psychology?

Answer 5

The application of psychological research and theory to therapeutic practice with an aim to improve well-being, reduce physiological distress and resolve crises
This application of theory is one of the main differences between counselling psychologists and counsellors

Question 6

What is the difference between counselling psychology and clinical psychology?

Answer 6

Clinical psychology is more focused on mental disorders while counselling psychology is focused on providing advice and guidance, dealing with causes and prevention of psych disorders related to motivational and emotional problems in everyday life

Question 7

What is the focus on in counselling psychology?

Answer 7

Meanings, beliefs, context and processes both within and between people, which can affect psychological wellbeing
Focus on emotional, social, educational, health-related, developmental and organisational functioning
HOW a counsellor interacts with the patient is more crucial than WHAT that interaction entails i.e. value is grounded in the PSYCHOTHERAPEUTIC RELATIONSHIP

Question 8

What is meant by a phenomenological model of practice?

Answer 8

Focuses on a person’s subjective internal experience and how they understand their own behaviour

Question 9

What are key aspects of a good psychotherapeutic relationship?

Answer 9

Need high levels of self-awareness, competence in relating skills, and also knowledge of personal and interpersonal dynamics involved in therapeutic contexts
Crucial to respect all client accounts as valid and to interpret and negotiate their perceptions without judgement
Shouldn’t impose own moral view but show respect for all different ones
The relationship essentially needs to be one between EQUALS - the person should be the centre of the session, not the skills/expertise of the counsellor; the counsellor should not be directing the session, suggesting interventions and techniques to PRODUCE change, but rather the client needs to realise that they can trust themselves and the validity of their own perceptions

Question 10

What are the 3 main principles of practice in counselling psychology?

Answer 10

Insight - promote client insight into origin, development, and maintenance of their problem in the hope that it will help them take control of their thoughts, emotions and behaviour and be in a better position to change them
Self-awareness - Promote client’s self awareness of their thoughts and feelings they may have been ignoring/denying
Self-acceptance - Help client become more accepting of themselves and develop a more positive self-view through identifying factors that have led to them holding negative ideas about themselves

Question 11

What is the ultimate aim of a counselling psychologist through adherence to these principles?

Answer 11

Reduce psychological distress in people with physical, emotional and mental difficulties, improving their wellbeing and helping to resolve crises

Question 12

What are the principles of the humanistic perspective?

Answer 12

Roots in humanism movement in which utmost importance attached to human values and the idea that humans have an innate drive to become a self-actualised and fully functioning individual with internal loci of evaluation and control
Natural internal drive towards growth and development (actualising tendency), and AUTHENTICITY is thought to be important in achieving this
When an individual harmonises with their actualising tendency it leads towards further positive growth and happiness

Question 13

What is the humanistic idea of actual vs ideal self?

Answer 13

The ideal self is who we want to be, the self our actualising tendencies are driving us towards and influenced by other people e.g. parental aspirations for their children
We constantly compare our actual with our ideal self, and congruence between them is important for wellbeing
Incongruence can impede actualising tendencies and lead to psychological problems

Question 14

What is meant by conditional positive regard?

Answer 14

One example of how incongruence can occur during childhood e.g. when a parent tells a child they don’t love them when they behave a certain way
The child adopts the parent’s conditions of worth and associates their self-worth with how they behave, careful to only behave in ways parents value
Parental aspirations become internalised into ideal self and this is what the child strives for rather than own desires –> inhibits self-actualising tendencies

Question 15

What aspects of interactions did Rogers argue can assist in moving towards self-actualisation?

Answer 15

Unconditional positive regard - acceptance and love regardless of behaviour
Genuineness - ability to express own individual sense of self instead of adopting a role or hiding behind a facade
Empathy - interactions with people who understand the world from that individual’s perspective

Question 16

What is person-centred therapy?

Answer 16

Preferred therapeutic technique in humanistic perspective, working on assumption that client difficulties arise out of obstruction of actualising tendency
Aims to free individuals from constraints stopping them from making use of their innate self-actualising ability

Question 17

What 3 main skills do counsellors need to facilitate person-centred therapy?

Answer 17

Empathy towards client - ability to empathise and communicate this effectively to the client, increasing client self-esteem
Unconditional positive regard - accept the client and show warmth regardless of behaviour/attitudes so client comes to value themselves as a result of being valued by the counsellor
Congruence of therapist feelings and behaviour towards client - important for trust to be built; congruence is a state when outward responses towards client consistently match inner feelings, enhancing the quality of responses given by a counsellor to a client and through trust-building, facilitating congruence in client themselves

Question 18

What is meant by active and complete listening?

Answer 18

Showing understanding by attending to and reflecting the root of the meaning contained in verbal and non-verbal messages of clients - observe and read non-verbal behaviour and listen in an integrated way

Question 19

What did Egan identify as the 3 aspects of listening?

Answer 19

Linguistic
Paralinguistic i.e. timing, volume, pitch, accent, pauses etc
Non-verbal i.e. facial expression, gestures, touch, body position and movement, eye contact etc (these are particularly good for communicating empathy and unconditional positive regard)

Question 20

What does SOLER stand for?

Answer 20

Behaviour adopted by a listener:
S - sit at comfortable angle and distance
O - open posture with arms and legs uncrossed
L - Lean forwards from time to time to show genuine interest and attentiveness
E - Effective eye contact (not staring)
R - Remain relatively relaxed

Question 21

What is paraphrasing?

Answer 21

Repeating back to client a summary of what they have said, demonstrating active listening and ensuring you have an appropriate understanding of what the client has said
When paraphrasing counsellor should ignore own ideas and attitudes - aim to be emotionally in touch with the client yet at the same time separate

Paraphrasing is also known as reflection of content
Reflection of FEELING can also be helpful, demonstrating to the client that the counsellor perceives what they are feeling and WHY they are experiencing such feelings

Question 22

What is an appropriate counselling set-up?

Answer 22

Chairs at right angles to each other, allowing client to look past counsellor without turning head away
No sense of confrontation or threat

Question 23

What is the psychodynamic perspective?

Answer 23

Based on Freud’s ideas that an important part of mental functioning is the unconscious - contains memories, thoughts and feelings which may have been repressed to avoid pain
This perspective involves exploring association between early experiences and how they might relate to current distress, aiming to bring unconscious feelings and memories into conscious awareness so links can be made between past experiences and present behaviour, allowing integration of previously unknown parts of themselves into present/future self

Question 24

What is always carried out in the psychodynamic approach to counselling?

Answer 24

An initial assessment to gather info to help counsellor establish possible causes of current problems and conflicts
INTERPRETATION is a big part of the counsellor’s role in this approach
May ask about factual material but also goals etc

Question 25

What happens as the client progresses through psychodynamic therapy?

Answer 25

Counsellor develops ideas about why client behaves in certain ways and they will offer these interpretations to the client
Sharing of interpretations in this way brings into conscious awareness what the client is unconsciously communicating, and over time the client will develop insight into their own problems that will start to help them resolve current difficulties

Question 26

What are the 3 rules for therapeutic relationships within this perspective to help a client feel comfortable revealing repressed thoughts and feelings?

Answer 26

Rule of abstinence - holding back from responding
Rule of anonymity - reveal nothing of self to client, allowing for transference and counter-transferance
Rule of neutrality - neutral stance so client learns to understand things for themselves, rather than being TOLD by the therapist (counsellor should never try to influence client)

Question 27

What are transference and counter-transference?

Answer 27

TRANSFERANCE - when client treats therapist as if they were someone else in their life; this is encouraged as a good way to draw out emotions from the past
COUNTER-TRANSFERANCE - result of transference, involving the therapist responding to the client as if the client was someone else - this can provide insight into the relationship between client and this other person, as feelings stirred up in the counsellor provide insight into how others may feel about the client and in turn how the client might relate to others

Question 28

What is the systemic perspective?

Answer 28

Understands families as an interacting system, and individual dysfunction is seen as a symptom of family dysfunction
Problem behaviour may serve a function within the family, may reflect family inability to function properly, or could result from inter-generational transmission of dysfunctional behaviour (nature/nurture) e.g. generations of struggling to show affection for children

Question 29

What does the systemic perspective assume?

Answer 29

A change in one part of the system (family) will influence other members i.e. an individual’s problems are best understood through considering interactions within the whole family because it may be dysfunction there that is the root cause rather than individual psychopathology

Question 30

What is Bowen’s multigenerational family therapy?

Answer 30

Considers at least 3 generations, and their intergenerational transmission of relationships/behaviours
Predictable patterns of relationships between members connects the functioning of family members across generations, stemming from unresolved emotional issues
Uses genograms - way of collecting and organising important information about a family over at least 3 generations

Question 31

What is triangulation?

Answer 31

Idea in which anxiety within an intimate relationship between 2 individuals can be reduced by introducing a third member e.g. parents drawing a child into marital difficulties

Question 32

What is Minuchin’s Structural Family therapy?

Answer 32

Understands structure/organisation of family systems by looking at interactions between family members - identify, for example, that an individual’s problems may be a diversion from wider family problems e.g. attention within a family on an anorexic member can divert from addressing difficulties operating in family system as a whole
Key concepts are family structure, family subsystems and boundaries and the focus of treatment is on changing the family structure rather than changing individual family members

Question 33

What is strategic family therapy?

Answer 33

Focuses on solving current family problems rather than issues rooted in the past
Problem presenting with is not addressed simply as a symptom of some other systemic dysfunction but rather as something involving the need to develop problem solving and coping skills

Question 34

What are the 4 aims of family therapy?

Answer 34

Understand family dynamics
Discover and activate psychological resources of the family
Work with family members to change their relationships with each other to reduce dysfunctional behavioural symptoms
Help family members develop problem solving and coping skills

Question 35

What is the primary goal in family systems therapy?

Answer 35

Produce VISIBLE CHANGE in behaviour - two possible methods include art therapy and the family sculpting technique in which family members place themselves in postures symbolic of family dynamics
Each person sculpts how they see the family at that moment and then how they WANT it to be
The physical movements between the two scenarios show the possible changes people could make to create their ideal family

Question 36

What is the cognitive-behavioural perspective?

Answer 36

Focuses on link between how people think and their behaviour, and aims to help client understand own thinking and how it could be impacting on emotions and behaviour
Ultimate aim is to help them change thinking to change behaviour

Question 37

What are Beck’s “automatic thoughts”?

Answer 37

Most commonly negative, thoughts that clients aren’t always aware of - pop into the head from nowhere, neither realistic nor helpful
Although individuals may not be AWARE of these thoughts, they could LEARN to identify and record them

Question 38

What does CBT typically involve?

Answer 38

8-12 sessions, between 3-6 months of structured intervention (not just free talking)
Involves goal setting and the process involves identifying negative and maladaptive patterns of thoughts to help explore alternative ways of thinking
Essentially CBT is all about breaking the cycle - thoughts are treated as hypotheses to be tested and challenged
There is also homework involved, and the technique only works when clients are willing to fully engage - can include keeping a journal of events and associated thoughts

Question 39

What is the Rational Emotive Behavioural Therapy model?

Answer 39

Model for thought diaries based on model of emotional disturbance
Fundamental theory is that our emotions stem from our beliefs, evaluations, interpretations and reactions to life situations
We can learn irrational beliefs during childhood and create our own irrational dogmas and superstitions which then stay with us through self-repetition and reinforcement
One such irrational belief could be “I must have approval from significant people in my life” - through therapy a client will learn to identify, refute and replace such beliefs and change their emotional reactions to situations as a result
This is also known as the ABC theory of emotions:
A - activating event i.e. something happens to you
B - Beliefs or interpretation of the activating event
C - Consequences of belief, including feelings and behaviours
D - Disputations of beliefs, challenging them to create new consequences
E - Effective new beliefs, more adaptive

Question 40

What is the main problem with having so many equally dominant perspectives in counselling psychology?

Answer 40

Hard to know which are most effective

Choice of approach is often best chosen by client and what they feel comfortable with

Question 41

Describe key evidence in support of the different approaches

Answer 41

Greenberg et al - support for person-centred therapy
Butler et al - psychodynamic theory can be effective for things like severe personality disorders
Multiple studies have shown effectiveness of systemic therapy e.g. for anorexia, but family problems have also been shown to re-occur often as a result of family collusion in withholding information
Butler and Beck - CBT works for a number of problems, particularly effective for anxiety and depression