Counselling Tutor Podcast

Latest Episodes:

041 – Writing Case Studies – Carl Rogers’ 19 Propositions – Counselling Skills Apr 29, 2017

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In episode 41 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly describe how to write a case study. 'Theory with Rory' looks at how best to apply the 19 propositions when writing case studies and assignments. Last, the presenters talk about diversity in the counselling room. Writing Case Studies (starts at 3.26 mins) Ken and Rory offer a number of tips on writing case studies as a student: Always check the criteria set by your awarding body before you start writing. Open the case study with a 'pen portrait' of the client - e.g. age, gender and presenting issue. Continue by describing the client's counselling journey, from start to finish. Depending on the criteria you are working to, there are various themes you can develop - for example, ethics, the theory of your modality, and your self-awareness during the work. It is always good to reflect on your own learning from your sessions with the client, and how you might approach things differently in future. Carl Rogers' 19 Propositions (starts at 13.51 mins) The 19 propositions were developed by Carl Rogers, the founder of person-centred therapy. They describe his theory of personality, expressed in terms of how a human being perceives the world (i.e. phenomenology). This part of person-centred theory is often seen as particularly hard to 'decode'. Rory has done so previously in Counselling Tutor Podcasts 13 and 14. One key tip he offers when reading Rogers' original wording is to swap the word 'organism' for 'person'. Rory offers three insights into how you can make maximum use of the 19 propositions when writing case studies and assignments. For example, you can use this theory to: evidence how clients engage with their incongruent selves describe how, in making sense of their reality, clients can transcend it (as the philosopher Edmund Husserl believed that once indivuduals understand their reality, they can then transcend it) explain how clients engage with their truth and what changes they make as a consequence of that. Key to all these is to use client statements from counselling interactions to illustrate your points. For more information, you can download Rory's handout, 'Three Positions in Phenomenology: The 19 Propositions'. Counselling Skills (starts at 19.40 mins) In counselling training, it is harder to demonstrate our use of skills than our understanding of theory (which can be written about in assignments). Because our work with clients is subject to confidentiality, we must showcase our grasp of skills through simulated sessions with peers. This can feel rather artificial, with a pressure to somehow slot in every skill in order to meet the criteria. Ken's new book, Basic Counselling Skills: A Student Guide is a great resource for skills development at all qualification levels. Uniquely, this includes links to online audio recordings of skills demonstrations. The effect of each skill is explored. As shown in research by Catherine Goldsmith at the University of Manchester, which led to the dodo bird conjecture, the key to effective therapy is primarily the relationship between the patient and therapist. Good counselling skills are key to building this relationship. Rogers used to audio record client sessions and listen back to these for learning. Recording is really useful for student counsellors; Ken strongly recommends doing so as much as possible (with client consent). Voice recorders can be purchased inexpensively these days.

040 – Personal Boundaries – Melanie Klein’s Object Relations Theory – Diversity Apr 01, 2017

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In episode 40 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss personal boundaries for counsellors. 'Theory with Rory' explains object relations theory, as developed by Melanie Klein. Finally, the presenters talk about diversity in the counselling room. Personal Boundaries (starts at 2.19 mins) Ken and Rory offer a number of tips on maintaining personal boundaries as a counsellor: Our counselling training means that we sometimes can't help but pick up the emotions and experiences of people we are talking to in social settings. It is important to learn to switch off from counselling, as it would be both unhealthy and unethical to counsel someone in this situation. Don't overshare with people - it can be especially easy to do this on social media, where your sharing will be stored forever. If you feel tempted to do so, try to reflect on your reasons for this (which may relate to transference or to needing therapy yourself to offload issues), and use your journal, personal development group and/or supervision to explore it. As counsellors, we may sometimes see clients when we are out with our family/friends. Explain to your family in advance that if someone they don't know greets you when you are out, you will not be able to tell them how you know them. Similarly, don't 'out' colleagues to your family/friends - your fellow counsellor may not wish others to know about their work. To conclude, Ken reminds us that boundaries are intended to be firm not elastic, and Rory points to Spiderman's words that 'with great power comes great responsibility'. Melanie Klein's Object Relations Theory (starts at 14.39 mins) Melanie Klein was an Austrian-British psychoanalyst who worked with Sigmund Freud but ultimately parted ways with him. While Freud believed that we as humans are driven by libido (i.e. an aggressive sexual energy), Klein asserted that we are driven by object relations, especially how we bond with significant caregivers and ourselves. Klein's theory was therefore related to attachment. Klein looked at how very young children initially view the world, and begin to regulate themselves, in response to their experiences of relationships. If a baby's needs are consistently not met, their experience of connecting with others can become split or fragmented. Klein characterised this split using the concept of 'good breast, bad breast', describing the two parts of the maternal object. The youngster can take this split within themselves, and it can even contribute to the development of borderline personality disorder (in which the person has not been able to fully integrate the various parts of self). This theory has contributed to the move from foster care being institution-based to foster children being placed with families. Rory provides more information on object relations theory and how it applies to counselling practice in his free download, 'Five Observations on Object Relations'. Diversity (starts at 22.58 mins) In the UK, the Equality Act 2010 requires equal treatment of all in employment access and in private and public services, regardless of the nine protected characteristics of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation. It is important to think about how you adhere to this in your counselling practice. However, understanding diversity and accepting difference in others is about more than just meeting legal requirements. Each of us experiences the world in a unique way, and it is vital for counsellors to avoid making assumptions and generalisations about others based on their own individual experiences. Our own 'truths' may come from the media, what our family has told us, our own experiences, and our experiencing of others. Rory recommends that to gain an insight into how women might experience the world, male therapists should read The Beauty Myth by Naomi Wolf and The Second Sex by Simone de Beauvoir.

039 – First Sessions with Clients – Integrative versus Eclectic Therapy – Measuring Client Progress Mar 25, 2017

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In episode 39 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about meeting new clients for the first time. 'Theory with Rory' examines the difference between integrative and eclectic therapy. To conclude, the presenters talk about ways of measuring improvement in clients. First Sessions with Clients (starts at 4.40 mins) Rory explains that he always offers clients a drink when they arrive; he does not agree with the idea that they could 'hide behind it' or use it to 'swallow their emotions'. After providing this and exchanging a few pleasantries (e.g. about how they found their journey), he goes into contracting. Contracting can be tricky if the client immediately starts to pour out their story/issues. Ken explains that we can help prevent this by our own words at the start of a first session, for example not asking before contracting, 'How are you feeling today?' If it is just not possible to complete the full contract at the very start, it really is vital to cover confidentiality and its limits before letting the client open up. Ken offers potential new clients a session of 20-30 minutes free of charge; this is specifically not a counselling session, but simply a chance to meet, provide information and discuss expectations. Of course, this may not be possible in an agency setting, where the first meeting may be the first full session. It is not unusual for a client to talk virtually non-stop in the first session, and you may be left feeling that you have had little chance to 'get in' and use your skills. But this chance will come in subsequent sessions, when you can explore the material more deeply. Conversely, a new client may be very quiet. This is not necessarily therapeutic silence (even Carl Rogers admitted that some silences could be awkward and unhelpful), and Rory suggests these prompts in this situation: 'I wonder how often you get the opportunity to talk about yourself.' 'I wonder how you feel about the idea of talking to a stranger about your issues.' There is also a section on opening sessions in Ken's new book, Basic Counselling Skills: A Student Guide. Integrative versus Eclectic Therapy (starts at 20.05 mins) Rory uses the metaphor of a disco to explain the key difference between these two types of therapy, comparing the DJ who seamlessly segues from one genre of music to another to the DJ whose transition jars and sends people scuttling off the dance-floor to sit down! He provides a couple of real-life examples from a past student of his, who had experienced this jarring effect when exposed to a couple of writing-based 'homework' techniques that had never been referred to - let alone fully explored - in subsequent counselling sessions. However, eclecticism doesn't have to be bad, if used carefully - it's more akin to having a toolkit, which contains a number of possibilities, whereas the integrative approach takes various pieces and fuses them together into a new tool. Integrative approaches work best when the modalities they seek to combine have common features. For example, the fact that both person-centred counselling and cognitive behavioural therapy (CBT) focus on the here and now means that these two can be integrated to good effect. Similarly, an eclectic approach can be effective if the therapist is well grounded in one modality, but occasionally steps out of that to use a technique from another approach if that seems to best serve the needs of the client. For example, an eclectic therapist may have a person-centred basis, but move into empty-chair work (gestalt) or ask about an activating event (CBT). For more information on the advantages and disadvantages of an integrative approach, see Rory's downloadable handout. You can also watch Rory's lecture in the Counselling Study Resource. Measuring Client Progress (starts at 27.10 mins) As a person-centred counsellor, Ken is not naturally draw to assessment forms and instead prefers to ask the client to reflect on their own progress, so that the information is coming from their frame of reference. However, many counsellors working in organisations will find that they have to use these types of tools, e.g. GAD (Generalised Anxiety Disorder), particularly where funding is based on outcome measures. It is important to be trained in how to administer these. There may also be other key performance indicators (KPIs) for counsellors, e.g. DNA ('Did Not Attend' rates. However you measure client progress, it is useful to do so at least every six sessions. This is helpful for both the client (in terms of seeing their own progress) and the counsellor (for checking how we are working with them, and whether we could be doing so more effectively). Reviews also help protect clients from becoming dependent on the counsellor, and from transferential issues (e.g. if the client is coming for other reasons than to receive therapy).

038 – Law in Counselling and Psychotherapy – Seven Stages of Process – Endings Mar 18, 2017

Show notes

In episode 38 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss the laws relating to counselling. 'Theory with Rory' examines the seven stages of process. Last, the presenters talk about endings in counselling. Law in Counselling and Psychotherapy (starts at 5.17 mins) Rory and Ken preface this section of the podcast by explaining that the legislation they are discussing is that relating to the UK, and that they are not qualified lawyers. They recommend Peter Jenkins' book, Counselling, Psychotherapy and the Law, published by Sage in 2007, as a reference source in this area. The new Ethical Framework for the Counselling Professions, which was developed by the British Association for Counselling and Psychotherapy and came into effect on 1 July 2016, specifically requires that we 'give conscientious consideration to the law and any legal requirements concerning our work and take responsibility for how they are implemented' (p. 9). Key to counselling practice is the Data Protection Act 1998, which relates to how client information is stored and who can access this (in general, the therapist, the client, coroners and judges). The Data Protection Act applies not just to clients but also to those who make enquiries about services (e.g. people who email a private practitioner, or fill in their web enquiry form). The Information Commissioner's Office can provide information on all this. Counselling agencies may require access to notes made by their therapists, and may specify how these should be structured and stored; if so, it is important to cover this when contracting with clients. Other important areas of law for agencies are insurance, and health and safety (including fire regulations). If you are writing an assignment (or part of your external portfolio) about your agency's legal processes, a good starting point is its policies and procedures. The main laws that you need to be aware of when contracting with clients about the limits of confidentiality relate to the prevention of terrorism, drug trafficking (the bulk movement of drugs) and money laundering (concealing the origins of money that has been obtained illegally). Additional requirements to break confidentiality (e.g. on the protection of children and vulnerable adults) usually exist in agencies; although these do not apply in private practice, many such counsellors may choose to follow them for ethical reasons. If you do ever need to break confidentiality, you could go to the relevant authorities (via your agency, if you work in one) or you could report it anonymously through Crimestoppers. If you do the latter, you must record this, so you have proof that you have done so if you are ever challenged on this (e.g. in court). Seven Stages of Process (starts at 21.44 mins) Rory believes that the seven stages of process, part of person-centred theory (as originally developed by Carl Rogers) is the 'most marvelous piece of theory ever written in the lexicon of psychology'! It describes clearly the path by which clients move from a fixed and rigid view of the world to a more fluid position, in which they can 'live life on life's terms', accepting responsibility for how they interact with and influence the world around them. The seven stages of process are one of the three pillars of the person-centred approach, the other two being the 19 propositions (Rogers' theory of personality) and the six necessary and sufficient conditions for therapeutic personality change. In his book On Becoming a Person (published in 1961 by Constable), Rogers (p. 131) writes: The seven stages of process provide a valuable common language with which to discuss clients in both supervision and case studies. Rory describes typical features of each stage, and asks: what stage do you think you are at? Why not take your views on this into your personal development group? For more information on the seven stages of process, watch Rory's lecture in the Counselling Study Resource and read the chapter dedicated to the application of this theory in Ken's newly published book, Basic Counselling Skills: A Student Guide. Endings (starts at 34.52 mins) Ken and Rory discuss endings in counselling, offering a number of tips: Plan for endings where possible, seeing ending as a process not a one-off event. Start at the very beginning of the therapeutic relationship by explaining to clients in contracting any limits on the number of sessions available. Remind clients each time you meet how many sessions they have left. Build in regular reviews of how the client is experiencing counselling. If, as the therapist, you need to take a break from counselling (e.g. if you are going on holiday), try to give clients one week's notice for each month you have been working with them. Think about how you would respond if a client seemed to you ready to end but was resisting doing so. If you feel sad when ending with a client, and feel you will miss them, take this to supervision and, if the feeling persists, to personal counselling. Think about how your own attachment style may impact on your endings with clients. Read the chapter on endings in Basic Counselling Skills.

037 – Transference and Countertransference – Unconditional Positive Regard – Your Research Project Mar 11, 2017

Show notes

In episode 37 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about transference in the counselling room. 'Theory with Rory' examines unconditional positive regard (UPR). Finally, the presenters talk about doing your research project. Transference and Countertransference (starts at 3.48 mins) Transference occurs when you meet someone new, and attribute to them issues, behaviours and fantasies that relate to someone from your past. In other words, you bring the whole history of an old relationship into the new relationship, rather than seeing the new person for who they really are. What happens when your client experiences transference in the therapy room? It can be hard to spot that this is happening, and can even lead to countertransference - when you react to the way the other person is acting towards you (in other words, you 'play the part' of the person in their history). Of course, it can happen the other way round: you, as a therapist, may experience transference towards the client, and the client may respond with countertransference. Either way, ask yourself: 'Who am I to the client? And who is the client to me?' Ken and Rory provide some practical tips on how to notice and tackle transference and countertransference: Develop your self-awareness so that you are more likely to notice and deal with transference, and to avoid responding with countertransference. Look out for the client 'acting out' or being very familiar towards you: these may be warning signs that they are experiencing transference towards you. Do you feel parental towards your client? If so, this could be a warning sign of transference. If you feel transference is taking place, ask your client: 'Do I remind you of anybody?' Take any issues of possible transference to supervision: a good supervisor is always looking out for this. Check out more resources on transference and countertransference in Podcast 3, and find out about eroticised transference in Podcast 21. Unconditional Positive Regard (starts at 17.20 mins) Counselling students often wonder: 'How can we look at all our clients with no judgement whatsoever? Is this possible?' Illustrating his points with real-life examples, Rory talks about our tendency as humans to see only the parts of others we don't like, and to dismiss or judge them on this basis. Carl Rogers described the importance of UPR in his paper, 'The Necessary and Sufficient Conditions of Therapeutic Personality Change', published by the Journal of Consulting Psychology in the 1950s. In this, he wrote (p. 97): Even Rogers admits that he did not always find it easy to show UPR, citing an example of a session with an army officer in South Africa during the time of apartheid. Rogers said that he struggled to offer UPR in this case, but the officer reported he had felt accepted and that the session had been life-changing. Rory offers three tips on UPR: Don't just accept the parts of a person that you like. Try instead to see and reflect back all that the person is saying, not auditing or correcting the parts that you don't like. Remember the quote: 'I disapprove of what you say, but I will defend to the death your right to say it. (It is unclear who said this, some claiming it was Voltaire, others refuting this.) In other words, freedom of speech matters. It is not up to us to seek to change the client's world views; instead, it is our job to help them make sense of their world, and to start the process of self-healing. Counsellors are not agents of social control. It is really important that we see clients as fellow human beings, who are the results of the paths they have walked. We must somehow separate the sin from the sinner. Your Research Project (starts at 25.32 mins) In the UK, counselling training courses at level 4 and above typically include the need to complete a research project. This can feel quite daunting - working out where to get the information you need, how to bring it all together, what to put in and what to leave out, and how to present it to the class without getting overcome by nerves. Ken and Rory offer their insights into this task, and recommend a book, Rory's Easy Research. This offers great tips on doing your research project, using the acronym SMARTER: specific, measurable, agreed, realistic, ethical and recorded. This is available through our Counselling Study Resource and as a free download from this podcast (see link below).

036 – Using Counselling Qualifications Overseas and in Other Roles – Congruence – Funding for Counselling Training Mar 04, 2017

Show notes

In episode 36 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss the viability of using counselling qualifications in other countries and in other areas of work. 'Theory with Rory' looks at congruence, and then the presenters talk about funding for counselling training. Using Counselling Qualifications Overseas and in Other Roles (starts at 3.05 mins) Are counselling qualifications gained in the UK portable to other countries? Rory reports that the set-up in the USA is very different from the UK, with a master's degree required, as well as passing an exam to gain entrance to the professional body there. Therapists in the USA have much more of a diagnostic role, and need to understand how to claim payment from insurance companies, given that most healthcare (including counselling and psychotherapy) is funded in this way. Ken notes that South Africa too has an insurance-based healthcare system. In short, each country has its own unique set-up in terms of how therapy works there. The main tip is to contact the professional body for counselling and psychotherapy in the country you are interested in, and ask whether your qualification would be accepted there, and whether any bridging courses or arrangements would be needed. Don't forget too to check out whether you would need a work permit to be allowed to work there. Counselling skills are potentially portable not only to other countries but also to other areas of work in the UK, for example nursing and teaching. Rory describes counselling qualifications as 'CV gold', given that they demonstrate a range of aptitudes and attitudes: interpersonal skills understanding of standards and ethics self-awareness commitment to learning, and to personal and professional development mental toughness and perseverance Have you experience of using your counselling qualification abroad or in another profession? If so, do share your experiences and views on our Facebook group. Congruence (starts at 12.55 mins) Rory models congruence by explaining that he usually reads from a script for his theory slot, but this time is not doing: which do you prefer? Rory talks about congruence, one of the six conditions described by Carl Rogers in a paper, 'The Necessary and Sufficient Conditions of Therapeutic Personality Change', published by the Journal of Consulting Psychology in the 1950s. Congruence is all about being genuine and real. After the strong influence of the psychoanalytical approach in the 1940s, in which the therapist specifically avoided connecting with the emotions of the 'analysand' (as the client was known), Rogers' approach represented a sea change. Rory provides several examples of where he has used congruence in his practice and found this to be effective. He believes that when he is real with a client, this helps build and deepen the therapeutic relationship, enable the client see him as real, and become real themselves. However, being real can be easier said than done. Rory offers some observations on how to achieve this, based on his own experience: Be yourself - in the words of the band Oasis, in their song 'Supersonic, 'I need to be myself; I can't be no-one else. Don't hide behind a professional façade and/or become defensive. If you're wrong, own it - this models the idea that it is OK to make mistakes. The Ethical Framework for the Counselling Professions, published by the British Association for Counselling and Psychotherapy, states (2015, page 10): 'We will ensure candour by promptly informing our clients of anything important that has gone wrong in our work together, and … offer an apology when this is appropriate.' If you don't know the answer to a question asked by the client, admit it. Funding for Counselling Training (starts at 28.12 mins) Counselling and psychotherapy training is expensive. Many UK public-sector colleges offer access to government-supported loan schemes, though these can change from year to year. Currently, Advanced Learning Loans are available to those aged 19 or over who are studying at Level 3 to 6. These tend not to be available in private colleges, but they may well allow you to pay in installments. If you don't finish the course, you may have to repay the course fees straight away. Also, it is not always possible to transfer to a different college partway through a course. Before you start a course, it is worth adding up the costs of the various different elements that may be required to complete it, for example: course fees supervision insurance membership of professional body travel personal therapy residentials time away from paid work

035 – When a Client Judges You – Psychological Contact – When a Client Cries Feb 25, 2017

Show notes

In episode 35 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss how to deal with clients who show prejudice towards you. 'Theory with Rory' explains the 'hidden condition' of psychological contact. Last, the presenters talk about what to do when a client cries in the therapy room. When a Client Judges You (starts at 4.20 mins) As student counsellors, we learn about equality and diversity, with the aim of being able to show all clients unconditional positive regard (UPR). But what if a client appears to show a prejudice towards us on the grounds of variables that have nothing to do with our counselling ability, e.g. gender, clothing, age or weight? There is no easy answer here, nor any one answer that would be appropriate in every situation, but Ken and Rory offer a number of general tips: Remember that this is the client's 'stuff', not yours. If you are sure of this in yourself - i.e. you feel secure and confident as a counsellor - then a client holding a view that you cannot counsel them because you are (for example) 'too young' will not feel hurtful to you. Try reflecting the view back to the client, as an interesting lens on their process, exploring where their concern is coming from. For example, if it has arisen from a lack of understanding on the part of the client of what counselling is and how it works, you could re-explain this. Or if it stems from something in their past experience, you could support them in looking at it. If the remark did feel hurtful to you, take this to your personal-development group and/or your supervisor, so you can explore what it is within yourself that has led to you reacting to it in this way. Finally, if an organisation seems to be judging you on something that doesn't relate to your ability as a counsellor, remember that they must abide by the Equality Act 2010. Psychological Contact (starts at 18.08 mins) Rory examines the first of the hidden conditions of Carl Rogers. The three core conditions - congruence, UPR and empathy - are relatively well-known, though Rogers never actually used the term 'core conditions'. But in fact Rogers held that six conditions are necessary and sufficient to bring about constructive personality change. He described these in a paper, 'The Necessary and Sufficient Conditions of Therapeutic Personality Change', published by the Journal of Consulting Psychology in the 1950s. The first of the six conditions is that the counsellor makes psychological contact with the client (i.e., they are 'on the same page' psychologically). Rory explores the possible barriers to this, which include: the client not understanding where they are and what they have come for - e.g. being under the influence of drugs or alcohol the client and counsellor being unable to understand each other's language the client looking not for counselling but for something else, e.g. friendship or expert advice (perhaps medical or legal) there being a mismatch in the communication styles of the client and counsellor (for example, if one uses a lot of metaphor but the other finds this difficult) the client having a mental-health condition (e.g. schizophrenia or memory loss) that means they do not share the reality of others). Although this may be a barrier, Rogers objected to the pathologising of such conditions (which relies on the medical model) and asserted that person-centred counselling could still be helpful. Even if it is not, other forms of talking therapy may be of value, for example validation therapy for people with dementia. When a Client Cries (starts at 24.32 mins) It is natural that clients will sometimes cry in the therapy room, as this is a place where we encourage emotion to be experienced and talked about, but how is the right way for the counsellor to respond? Positive emotions are much more highly valued - and so accepted - in our culture, meaning that it can be difficult to cry in front of others. Ken and Rory give some tips, based on their counselling experience: Do have tissues available in the room, within arm's reach of the client (as not doing so might make it look as if crying is not welcome there). If a client starts to cry, don't automatically pass them the tissues or even mention that they are there: doing so can interrupt the flow of the client's process, plus it is the client's choice whether they wish to use them (some may choose to let the tears stream down). When a client cries, you could say: 'You're not on your own.' If a client apologises for crying, you could say: 'All of your emotions are welcome here.' Don't say, 'It'll be alright' (trying to rescue the client) or 'Don't cry!' (which is generally more about the issues of the person who says it than about the issues of the person crying). Remember that if a client is crying, it probably suggests they feel safe with and trusting of you and the environment. This brings the opportunity to do deep and beneficial work.

034 – Safeguarding Computer Data – Margaret Warner and Fragile Process – Confidentiality in Counselling Feb 11, 2017

Show notes

In episode 34 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about how to store digital backups of notes and documents securely. 'Theory with Rory' looks into Margaret Warner's work on fragile process. Finally, the presenters discuss practical issues and tips regarding client confidentiality. Safeguarding Computer Data (starts at 2.12 mins) These days, we tend to store study notes electronically. But what happens when data gets lost, corrupted or inadvertently deleted? Ken and Rory suggest using a cloud-based server (e.g. Google Docs or Dropbox) to store copies of documents remotely. Another option is to get a software program on your computer that backs up your documents online, for example CrashPlan. With regard to client notes, an external hard drive that is password-protected may be a good solution for backing up data. It is important never to dispose of hard drives or any other data-storage devices without properly removing any confidential data. Margaret Warner and Fragile Process (starts at 18.19 mins) Rory explores the nature of fragile process, a concept developed by US psychotherapist Dr Margaret Warner, who used the person-centred approach in clients with active psychosis. It is sometimes thought that person-centred counselling is inappropriate to use with this client group, who experience different realities from other people. Warner's work seeks to de-categorise and de-pathologise psychotic conditions, and so highlights the contrast between the medical model (which asks: 'What's wrong with you?') and the psychosocial model (which instead asks: 'How did this happen?'). It is possible to work with psychosis using the person-centred approach, but only with lots of training and experience. To understand a client's fragile process, it is important to explore its cause. For example, Warner has worked with people who were sexually abused as children. Someone who has experienced sexual abuse in the first seven years of life may - through their inability to physically escape their abuser - have created a hiding place in their mind. For example, one young person might stare at the pattern on her wallpaper, and another might have an out-of-body experience, watching themselves from the ceiling, in order to cope with abuse. In this type of situation, the self-concept can 'crack' to form two or more personalities, leading to voice-hearing, an altered vision of reality, and odd bodily sensations. Clients with fragile process may have difficulties in: holding onto their experience regulating the intensity of their experience naming what the experience is talking about the experience. For therapists working with clients with fragile process, it is important to empathise with and give unconditional positive regard to both/all parts of the personality. Such clients often feel more comfortable to have control over the practical arrangements for counselling, for example to be able to choose a regular slot for therapy, for sessions always to start in the same way, and to choose and stick with the physical lay-out of furniture in the room. They may have difficulty in finding the words to describe their experiences, so therapists need to be patient and to allow time. In time, the client may be able to integrate the disassociated parts of their personality, and become whole again: the organismic whole, as Carl Rogers called it. Confidentiality in Counselling (starts at 23.55 mins) Ken and Rory discuss some practical issues relating to client confidentiality, and give the following tips: When you contract with clients, talk about what you would do if you bumped into them when you were out and about in your everyday life - for example, you might suggest to a client that you will not acknowledge them unless they acknowledge you first. Explain to your partner that you will be unable to discuss your counselling work with them, so that they understand if they witness you being acknowledged by a client when you are out, and they don't expect to be told who the person is and how you know them. Think about privacy in your counselling room. For example, if you open the window in warm weather, might the client's material be overheard by people outside? If you have a regular window-cleaner, tell them not to come on days that you are in practice as a counsellor. Hope for the best and plan for the worst!

033 – Counsellors in Schools – Postmodernism in Therapy – Insurance for Counsellors Feb 04, 2017

Show notes

In episode 33 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about the growth of counselling in schools. 'Theory with Rory' decodes 'postmodernism' and discusses how this affects the world of counselling and psychotherapy. Finally, the presenters discuss the importance of having professional indemnity insurance. Counsellors in Schools (starts at 2.12 mins) There is talk of ensuring that all schools in the UK have their own counselling service. A pilot project in Wales showed successful results. Children and young people these days face life in a complex world with many pressures; this can lead to feelings of overwhelm. It can be difficult or impossible for youngsters to share their concerns with relatives, especially when family may be part of the problem. Rory and Ken are strongly in favour of the development of such services, explaining that there would be benefits to: children and young people themselves - having the chance to speak confidentially to an independent person about any problems counsellors - bringing increased employment opportunities trainers in specialist skills for counselling children and young people - being able to offer this training to more counsellors. Ken and Rory assert that there is an ethical requirement for counsellors working in this field to have dedicated training. This is supported by the Ethical Framework for the Counselling Professions of the British Association for Counselling and Psychotherapy (BACP): 'Careful consideration will be given to working with children and young people that … demonstrates knowledge and skills about ways of working that are appropriate to the young person's maturity and understanding' (page 8). Counsellors in this field need to ensure they have the right skills and knowledge, for example of child development, social media, current recreational drugs and the Fraser guidelines. But don't be tempted to try to 'get down with the kids': teenagers generally see through this as unreal. Counsellor Tutor Podcast 15 looked at counselling young people, and members of the Counselling Study Resource can also hear an interview with counsellor Catherine Knibbs on working with young people - in particular, the impact of the internet. Postmodernism in Therapy (starts at 15.42 mins) What is postmodernism? Here, Rory 'decodes' the term, explaining that it refers to a mind-set that encompasses a general distrust of theories and ideologies that seek to slot all knowledge into a single framework. In other words, postmodernism challenges the 'big ideas' that we might assume to be true, and asks us to deconstruct and critically evaluate them. Rory looks at the history of postmodernism. In the 1600s, religion lost its monopoly in the West in explaining reality, with science taking over and leading to the Industrial Revolution in the 18th and 19th centuries. The 'big ideas' of commerce, science, literature, art and psychology formed important parts of the modernist era, while postmodernism (which followed modernism historically) represented a questioning by philosophers of the genuine usefulness of these ideas to contemporary society. In the world of therapy, the ideas of Sigmund Freud, Albert Ellis and Carl Rogers could be said to be modernist, since they all rely on particular theories. Postmodernist therapies, meanwhile, are highly relational, collaborative and phenomenological; they enable clients to deconstruct and examine their beliefs and the value they place on these. There are two main modalities in postmodern therapy: narrative therapy - which evaluates the client's thoughts and behaviours in the context of their culture and the story they have written for themselves solution-focused brief therapy - which creates solutions to problems rather than evaluating the root causes of these problems. Insurance for Counsellors (starts at 23.30 mins) Whether you are qualified and in practice, or a student on placement, it is important to have your own professional indemnity insurance, as required by the BACP's Ethical Framework: 'We will be covered by adequate insurance when providing services directly or indirectly to the public.' It also makes good financial sense to ensure you have insurance cover, since we live in an increasingly litigious society, and claims can prove extremely expensive. Ken and Rory offer three top tips on insurance: When deciding which company to go with, phone up and see what impression you get, and what's on offer. For example, some offer continuing professional development (CPD) and/or access to document libraries. Once you've bought a policy, always read the documentation - there may well be conditions (e.g. on note-taking, supervision and CPD) that you must adhere to for the insurance to be valid. Even if your agency says it has its own insurance, always take out your own too - sometimes an organisation can refuse to claim on its insurance for cost reasons.

032 – Recent Changes in Counselling – Thematic Apperception Test – Using Transitional Objects Jan 28, 2017

Show notes

In episode 32 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about recent changes in the world of counselling. ‘Theory with Rory’ then examines thematic apperception tests. Last, the presenters discuss the use of transitional objects. Recent Changes in Counselling Ken and Rory discuss how the world of counselling and psychotherapy has changed over recent times. Key developments, many of which have been made possible by new technology, include: the British Association for Counselling and Psychotherapy introducing a new Ethical Framework for the Counselling Professions, which includes reference to online therapy discussions on the profession moving towards becoming regulated counsellors being able to connect more easily with each other (e.g. through our Facebook page, Counselling Tutor), so helping to avoid professional isolation greater access to information on issues relating to psychological and emotional health (e.g. the recent disclosure through the UK press of sexual abuse in football), empowering people to talk about their own experiences new modalities emerging – for example narrative and solution-focused therapy the medical and social models moving closer to each other in mental health care people becoming increasingly isolated socially, and so being more in need of being listening to and receiving the core conditions counsellors being more likely to offer clients psycho-education (for which continuing professional development is especially important) counselling becoming less of a ‘cottage industry, and becoming more respected by other health and social care professionals. The presenters discuss whether the nature of the human condition and pain have changed; they conclude that they have not, but that people now have more opportunity to normalise their problems through greater exposure of others’ difficulties. This is in turn helping to lift the stigma of seeking counselling help. Thematic Apperception Test A thematic apperception test (TAT) is a projective psychological test that is designed to reveal a person’s needs, motives and concerns through how they interpret pictures showing emotionally ambiguous situations. Rory describes how participating in this activity changed his life in terms of inspiring him to enter the counselling profession. The concept of TAT was first discussed in the 1930s by US psychologist Henry Murray and lay psychoanalyst Christiana Morgan at the Harvard Clinic. It is said that the idea came from a question asked by a student, Cecilia Roberts, whose son – when ill – had spent the day making up stories about images in magazines. Roberts asked Murray whether pictures could be used in clinical practice to explore personality. The TAT also has a literary connection, with one of the chapters in Herman Melville’s Moby Dick describing what different characters see in the images on a coin. Murray was a great fan of Melville’s writings. After the Second World War, the test was adapted to fit various different approaches to psychotherapy, and was later used by the Human Potential Movement (which is based on the humanistic school of psychology) to help increase clients self-understanding and personal growth. It can be useful in revealing edge-of-awareness material, enabling clients to access their feeling and process. Using Transitional Objects This involves a counsellor giving a client an object of theirs to help see them through a break in therapy sessions through maintaining an intersubjective connection. As such, it is something to be thought out carefully – and so employed only by experienced counsellors in an established therapeutic relationship. Particular dangers to bear in mind are the risks of transference and dependence. Used properly, this technique may increase rather than decrease client power. Ken describes an activity he has used at the final stages of counselling, in which clients choose from a selection of small objects (feathers, pens, tape measures, dolls etc.) one that seems to fit with their personal journey. It might be possible to let them take their chosen item away with them as a transitional object. Ken and Rory conclude that the key to using transitional objects is to do so only with the right client, in the right relationship, and for the right reason.

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