Search results

Discusses four ways of conceptualising counselling: as a set of skills, as a relationship, as a means of attaining outcomes, and as a set of definable tasks. Considers the issues arising from the BAC definition of counselling, Patterson′s (1974) approach, and the debate about counselling versus psychotherapy. Surmises that the four conceptualisations of counselling are not mutually exclusive, but it is important to examine the exact nature of counselling in order to do the job well.

Research suggests that African-Caribbeans are less likely than their white British counterparts to ask for mental health support (Cooper et al., 2013). This is despite research identifying that minority groups as a whole, when compared to the white majority, report higher levels of psychological distress and a marked lack of social support (Erens, Primatesta, & Prior, 2001). Those who do request support are less likely to receive antidepressants (British Fourth National Survey of Ethnic Minorities, 1994; Cooper et al., 2010) even when controlling for mental health symptom severity, with African-Caribbeans less likely to make use of medication for depression even when prescribed (Bhui, Christie, & Bhugra, 1995; Cooper et al., 2013). Studies reporting on reasons for black people being less likely to attend for mental health consultation with their GP suggest a variety of explanations why this may be, focussing both on the suspicion of what services may offer (Karlsen, Mazroo, McKenzie, Bhui, & Weich, 2005) and the concern of black clients that they may experience a racialised service with stigma (Marwaha & Livingstone, 2002). Different understandings and models of mental illness may also exist (Marwaha & Livingstone, 2002). Different perspectives and models of mental health may deter black people from making use of antidepressants even when prescribed. Despite a random control trial showing that African-Caribbean people significantly benefit from targeted therapy services (Afuwape et al., 2010), the government, despite a report by the Department of Health in 2003 admitting there was no national strategy or policy specifically targeting mental health of black people or their care and treatment has not yet built on evidence-based success. One important aspect recognised by the Department of Health (2003), was that of the need to develop a mental health workforce capable of providing efficacious mental health services to a multicultural population. Although there were good strategic objectives little appeared to exist in how to meet this important objective, particularly in the context of research showing that such service provision could show real benefit. The Department of Health Guidelines (2003) focussed on the need to change what it termed as ‘conventional practice’, but was not specific in what this might be, or even how this could improve services to ethnic minorities. There was discussion of cultural competencies without defining what these were or referencing publications where these would be identified. There was a rather vague suggestion that recent work had begun to occur, but no indication that this had been evaluated and shown to have value (Royal College of Psychiatrists, 2001). Neither British Association for Counselling and Psychotherapy nor British Psychological Society makes mention of the need for cultural competencies in organisational service delivery to ethnic minority clients. This chapter will describe, explore and debate the need for individual and organisational cultural competencies in delivering counselling and psychotherapy services to African-Caribbean people to improve service delivery and efficacious outcomes.

In this chapter, the author critically examines the deeply entrenched practices and theories within counselor education, revealing their roots in historically dominant, Eurocentric, and often racially oppressive assumptions. This study brings to light the pervasive impact of these traditional approaches, illuminating their role in perpetuating racial oppression and disparities in mental health care. The author presents a compelling argument for adopting Critical Race Theory (CRT) as an effective pedagogical and clinical practice framework in the counseling profession, a step toward its much-needed liberation. CRT's tenets are examined as a robust alternative, promoting socially just outcomes in counseling and psychotherapy. The article highlights CRT's capacity to address the well-established relationship between racism, white supremacy, and minority mental health. It proposes a groundbreaking model for praxis, predicated on CRT, which holds potential not only to challenge and disrupt oppressive structures but also to pave the way for the liberation of both the oppressed and the oppressor. This seminal work prompts a re-envisioning of counselor education, asserting a call for a transformative shift toward a liberation-based, social justice pedagogy.

Dyadic services research has increasingly focused on helping providers facilitate transformative service conversations with consumers. Extant research has thoroughly documented the conversational skills that providers can use to facilitate consumer microtransformations (i.e. small changes in consumers’ thoughts, feelings and action plans toward their well-being goals). At the same time, extant research has largely neglected the role of servicescape design in transformative service conversations despite some evidence of its potential significance. To redress this oversight, this article aims to examine how servicescape design can be used to better facilitate consumer microtransformations in dyadic service conversations.

This article is based on an interpretive study of mental health services (i.e. counseling, psychotherapy and coaching). Both providers and consumers were interviewed about their lived experiences of service encounters. Informants frequently described the spatial and temporal dimensions of their service encounters as crucial to their experiences of service encounters. These data are interpreted through the lens of servicescape design theory, which disentangles servicescape design effects into dimensions, strategies, tactics, experiences and outcomes.

The data reveal two servicescape design strategies that help facilitate consumer microtransformations. “Service sequestration” is a suite of spatial design tactics (e.g., private offices) that creates strong consumer protections for emotional risk-taking. “Service serialization” is a suite of temporal design tactics (e.g., recurring appointments) that creates predictable rhythms for emotional risk-taking. The effects of service sequestration and service serialization on consumer microtransformations are mediated by psychological safety and psychological readiness, respectively.

The article details concrete servicescape design tactics that providers can use to improve consumer experiences and outcomes in dyadic service contexts. These tactics can help promote consumer microtransformations in the short run and consumer well-being in the long run.

This article develops a conceptual model of servicescape design strategies for transformative service conversations. This model explains how and why servicescape design can influence consumer microtransformations. The article also begins to transfer servicescape design tactics from mental health services to other dyadic services that seek to facilitate consumer microtransformations. Examples of such services include career counseling, divorce law, financial advising, geriatric social work, nutrition counseling, personal styling and professional organizing.

The paper addresses diversity, multi‐culturalism and mental health. It reports qualitative data from a larger project on multi‐cultural counselling competencies in Portugal which sought to meet the needs identified by specific minority groups by developing integrative, responsive and culturally sensitive treatments. A qualitative study is presented, with the aim of exploring the representations of mental health and illness held by ethnic minority groups in Portugal, as well as their specific needs and obstacles encountered in their interactions with health professionals. Semi‐structured interviews were conducted, and the results indicate that the meanings of health and mental health varied. Meanings of psychological health were related to general well‐being. Help‐seeking behaviours were associated with providing and receiving family and social support, mainly among participants of African descent. Although the great majority of participants had had no experience of counselling or psychotherapy, they expected psychologists to be multiculturally sensitive, as well as knowledgeable about diversity and multi‐culturalism. Implications for development of mental health services for minority clients are discussed.

This paper reviews the literature on therapeutic process specific to sexual offender treatment. The general clinical literature emphasises the importance of therapist style, the client's perceptions, the therapeutic alliance and cohesiveness. We highlight the importance of therapist characteristics, group cohesion and emotion in effective treatment of sexual offenders. Implications for programming and research are emphasised.

Deliberate practice (DP) is an innovative training method for improving psychotherapy skills acquisition and expertise in the twenty-first century. I introduce the reader to the principles and processes of DP and the rationale for its use. The concept of DP is not new, indeed it is used to support the improvement of performance in diverse areas, from sport to music. However, its application to psychotherapy is still in its infancy. Firstly, I provide the rationale for including DP as a method of therapist training based on research that illustrates that many of the current criteria that we use to identify expertise have little to no added impact on client outcomes. Additionally, some of the limitations of current traditional training regimes are outlined, along with the emerging evidence base for DP as a training method that can help improve the acquisition of therapeutic skills and expertise.

In the previous chapter, the reader will have become familiar with the idea of screening for traumatic experiences within organisations as a way to identify those who may benefit most from interventions and support. In this chapter, I present an overview of the trauma therapy literature in the first instance and then explore some of the debates regarding specific trauma-informed treatments versus general therapeutic approaches. The multicultural competency literature is discussed, and the multicultural orientation approach of cultural humility, cultural opportunity and cultural comfort is highlighted in a practice context. This chapter concludes with a case study vignette that brings it all together with a clinical example of what trauma-informed therapy through a multicultural lens might look like. As such I operationalise choice, collaboration , trust and transparency, and cultural principles from the trauma-informed care literature. Although applied here to specific trauma-informed organisations, some of the methods and processes that I unpack can be used in non-specific organisations where social/case managers are employed and wish to operationalise choice and collaboration in a structured way.

This study investigated the effectiveness of a new counseling program integrating cognitive behavioral therapy and acceptance and commitment therapy to promote emotional regulation (ER) among undergraduate students with depression.

An interventional mixed method design was employed with the development of a qualitative method-based program using experimental and qualitative research. The sample consisted of 792 third-year undergraduate students at a public university in Bangkok. A total of 34 students with depression voluntarily enrolled and were divided into 2 groups. The 17 students in the experimental group received integrated counseling, while those in the control group received brochures. The effectiveness was evaluated using the self-assessment section on the ER scale and the Beck Depression Inventory form before and after counseling. When the program ended, qualitative research was conducted using in-depth interviews. In terms of quantitative research, the data were analyzed using one-way MANOVA and the qualitative research data used content analysis.

The mean scores for ER and depression in the experimental group before and after counseling were significantly different (p-value <0.05). Results were also significantly different from the control group (p-value <0.05). Students with depression showed improvements in ER in all six components after joining the program, including awareness, clarity, acceptance, impulse, goals and strategies.

Integrated counseling is an effective program that can increase ER and reduce depression among adolescents and can be an alternative program for depressive patients or other mood-regulating problems to promote ER.

The recognition of the importance of addressing cultural issues in psychotherapy and counseling has been increasing. The present paper seeks to contribute to the specification of multicultural competencies in the fields of counseling and clinical psychology, based on clients’ perspectives. In particular, its objectives were to explore the experiences of individuals of ethnic minority groups regarding their access to the Portuguese healthcare system and to identify the multicultural competencies of the clinicians (as perceived by the clients) which would be required to improve culturally sensitive treatments.

The sample included 40 adults from different ethnic minority groups in Portugal – a total of 30 women and ten men – with a mean age of 34. Participants took part in one of eight focus groups, which were conducted using a semi‐structured interview plan.

Content analysis revealed that, generally, participants had experienced discrimination in the healthcare system, and that mental healthcare was perceived as mixed (both positive and negative). Furthermore, participants identified specific aspects of multicultural awareness, knowledge, and skills required of clinicians to provide culturally sensitive treatments, providing support for the tridimensional model of multicultural competencies.

Implications are discussed for ethical guidelines and clinical training of counselors, clinical psychologists, and other social and health professionals in Europe.