As counselling often deals with those who are vulnerable it has been characterised as a high risk professional, and as such, controversy has often surrounded the effectiveness of its methodologies (Vacc, Devaney & Brendel, 2003). Because of the wide range of theoretical and practical approaches existing in the field, there is an ever-present need to critically analyse counselling’s role in society, in conjunction with the evidence to support it. This essay will explore the scientific evidence surrounding counselling in New Zealand and analyse the significance, in terms of efficiency and effectiveness, that counselling has on individuals at the psychological and emotional level. This will be done by first giving a definition of counselling alongside pointing out the differences that make it distinct from other helping professions. Second, the nature and purpose of counselling will be outlined, alongside its intention and the prerequisites needed to facilitate interpersonal connection. Last, the value of counselling will be demonstrated by giving an analysis of the issues facing validation and then illustrating studies at both the international and national level to demonstrate clinical efficiency. It is concluded that the link between evidence-based research and counselling is one that requires stronger emphasis and through developing more counselling orientated research projects, a greater value will able to be placed on the role of counselling role within New Zealand culture.
It is difficult to give a definition of counselling that is both comprehensive and specific. However, a generalized description would state that counselling is collaboration between two people, where one person invites the other into an open, confidential, and non-judgmental relationship in order to achieve some sort of therapeutic purpose. Possible outcomes of this relationship include understanding, education, social skills, and practical solutions (McLeod, 2007). Counselling will often involve guidance, advice, teaching, listening, and empathizing. However, these qualities are not, in themselves, counselling. The context that the counselling is given in will determine the way it is applied, with a variety of social and cultural factors playing a part (McLeod, 2009). In New Zealand, these factors include such things as socioeconomic conditions and awareness of prevalent local cultural components, whether these are Maori, Pacific Islander, or Asian, for example. In addition to the definition given above, a distinction between those who are formally trained and qualified in the counselling field and those who practice ‘counselling type skills’ must also be noted (Corey, 2009). In the first instance, those who are qualified will have undertaken professional training in an accredited university or institute over several years. Additionally, upon completion of training, they will likely have accredited themselves to an association that oversees ethical and professional development. In the second instance, since there is no regulation of unqualified counsellors, it is unknown if those who practice without sanctioned training possess the relevant skill sets, empathetic attitudes, and knowledge needed to perform the practice.
The difference between counsellors and those in other helping professions who utilize certain aspects of counselling (such as nurses, social workers, and teachers) is that the counsellor’s only role is to be a counsellor. This is not true of other health professionals who practice embedded counselling, whereby integrating it into their own professionally separate practice (McLeod, 2007). Furthermore, those trained specifically in counselling would be expected to a background in counselling theory to accommodate their practice, where as those not trained in counselling may not have this type of knowledge. When making a contrast between counselling and psychology, the visible features of distinction become even more blurry, although they are still present. The main differences between the two surround training, legislation, organizational membership, professional identity, and the type of client that is typically seen (Sweeney, 2001). Psychology typically has a more structured and prolonged training period, more definitive legislation in place, larger and more influential professional bodies to be accountable to, alongside a public, and often professional, perception of higher status. Included in this difference is counselling psychology, a specialized part of psychological training that emphasizes a humanistic perspective, alongside preventative care in the form of education and awareness of developmental and ecological influences (Manthei, Stanley, & Gibson, 2004). It differentiates itself from counselling on the basis of its overriding support for empirical-evidence in choosing therapies to work with, the longer and more psychologically orientated training it encompasses, and future job possibilities for practitioners, since they are first and foremost, psychologists. The significance in making the distinction between those formally trained and those who are not, alongside counsellors and those in other mental health professions, is that it brings clarity and context when discussing matters of professional conduct, training, and practice; matters all relevant to a critical analysis of whether counsellors and the field they practice in, are able to be scientifically validated in practically relevant ways.
The nature and purpose of counselling varies according to the theoretical model being used, though it can generally be stated that counselling’s primary intention is to address psychological issues in a person’s life, alongside any matters, decisions, or crises that occur and affect mental health (Nelson-Jones, 2013). Typically, therapy is focused on issues that come up in daily life and can be solved within a limited time-frame, rather than in longer more intensive type therapies (Manthei, 1997). One example of this is clearly demonstrated in ‘solution-focused counselling’, which looks to focus on the client’s needs and preferred outcomes, whilst presenting them with, and co-creating, possible solutions to bring out desired changes in their lives (O’Connell, 2012). The impact of this approach is a direct and concrete change, usually within a minimal timeframe. In addition, regardless of the counsellor’s chosen theoretical approach, he or she will need to cultivate the necessary psychological and emotional conditions within themselves to be able to connect with clients on an authentic and ‘heart-felt’ level. While there will be many facets of the connection between counsellor and client for the therapist to develop, Rogers (1962) has identified five key aspects of the interpersonal relationship between counsellors and clients that are necessary for effective outcomes. These are congruence, empathy, positive regard, unconditionality of regard and the client’s perception. While the first four can be cultivated by the therapist, the fifth can be influenced somewhat by the therapist’s intention and actions as well. The importance of developing these key aspects is in the way that they help facilitate core principles of counselling as well as purposefully giving it direction.
Having established a workable definition of counselling, alongside pointing out its nature and purpose, it is now time to turn towards assessing the value of counselling in New Zealand. Over the past 25 years the number of counsellors in New Zealand has increased by over 900%, showing the need for this service, alongside critical analysis to ensure high standards. In an informal survey published in March 2013 on the effectiveness and frequency of those who had recently been to counselling sessions in New Zealand, raised the question concerning the way in which counselling therapy is applied, evaluated, and taught (Chisholm, 2013). In conjunction with this survey, the Chisholm also outlined the lack of evidence-based studies – particularly within New Zealand – to support nationally funded counselling, such as ACC’s ‘sensitive claims’ policy and Work and Income’s disability allowance (Disability Allowance, n.d; Sensitive Claims, n.d). In addition, a study recently conducted by Otago University investigating medical students’ communication during clinical consultations, showed a significant decline in empathetic responses from year five to year six, a result that is similar with international findings (Lim et al., 2013). The significance of this shows that clients who turn to medical doctors in relation to mental health issues, may not be receiving the type of ‘connection’ or ‘space’ that they need, and this may lead to an increase in counsellors and therapists in other professions to fill the gap. Furthermore, it emphasizes the need for counsellors to acquire and maintain rigorous professional standards.
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- Lee Hooper (Author), 2013, The importance of counselling in New Zealand, Munich, GRIN Verlag, https://www.grin.com/document/233137