COUNSELLING AND PSYCHOTHERAPY JOURNAL
HEALTHCARECOUNSELLING AND PSYCHOTHERAPY JOURNALJANUARY 2018 VOL 18, NO 1FOR COUNSELLORS AND PSYCHOTHERAPISTS WORKING IN HEALTHCAREEATING DISORDERS:IS INACTIONTANTAMOUNTTO NEGLIGENCE?08PLUSSUPERVISION AND TRAININGSUPERVISORS FOR IAPTAre we getting thebalance right? 13TENDING THE GROWING EDGE:COUNSELLING WOMENFOLLOWING BREAST CANCERThe role of counselling and the potentialfor post-traumatic growth HYPEREMESIS GRAVIDARUM:WHO CARES?18The psychological impact ofsevere morning sickness 24
2FROM THEEDITORThe HEALTHCARE Counselling andPsychotherapy Journal is the quarterlyjournal for counsellors and psychotherapistsworking in healthcare.It is published by the British Association forCounselling and Psychotherapy (BACP):BACP House, 15 St John’s Business Park,Lutterworth LE17 4HBT 01455 883300F 01455 550243The journal is sent free to members ofBACP Healthcare in January, April, Julyand October. Membership of BACPHealthcare costs 30 a year for individualsand 50 a year for organisations. Formembership enquiries, please emailhealthcare@bacp.co.ukEditorJoanna Benfieldhcpj.editorial@bacp.co.ukAssociate editorsPeter JenkinsEwan DavidsonBACP Healthcare teamExecutive Committee membersChair: Satinder PanesarDeputy Chair: Rachel JohnstonZubeida AliToby SweetKerry NairVicky PalmerBACP staffHealthcare administratorJudy StaffordWe welcome your queries andinformation on healthcare counsellingand psychotherapy-related issues.To get in touch, please email us athealthcare@bacp.co.uk or telephone01455 883300 and ask for the healthcareteam. Please remember to quote yourBACP membership number.Visit the BACP Healthcare website atwww.bacphealthcare.org.ukContributionsWe welcome contributions.Please contact the editor.For authors’ guidelines, seewww.bacphealthcare.org.ukAdvertisingFor rates, contact Adam LloydsT 020 3771 7203adam@thinkpublishing.co.ukPublications of advertisements and/orinclusion of advertising materials in theHEALTHCARE Counselling andPsychotherapy Journal does not constituteendorsement by BACP Healthcare or BACP.DesignSteers McGillan EvesT 01225 465546PrintNewnorth Print LtdDisclaimerViews expressed in the HEALTHCARECounselling and Psychotherapy Journal arethe views of the writer and not necessarilythe views of BACP Healthcare, or BACP.Publication in this journal does not implyendorsement of the writer’s view. Reasonablecare has been taken to avoid error in thepublication but no liability will be acceptedfor any errors that may occur.Case studiesAll case studies in this journal, whethernoted individually or not, are permissioned,disguised, adapted or composites, with allnames and identifying features changed inorder to ensure confidentiality.CopyrightApart from fair dealings for the purposesof research or private study, or criticismor review, as permitted under the UKCopyright, Designs and Patents Act 1998,no part of this publication may be reproduced,stored or transmitted in any form by anymeans without the prior permission in writingof the publisher, or in accordance with theterms of licences issued by the CopyrightClearance Centre (CCC), the CopyrightLicensing Agency (CLA) and otherorganisations authorised by the publisher toadminister reprographic reproduction rights.Individual and organisational members ofBACP only may make photocopies forteaching purposes, free of charge, providedsuch copies are not resold. British Association for Counselling andPsychotherapy 2018ISSN (print) 1475-0724ISSN (online) 2397-866XOne of the key focal points of healthcare policy in recentyears has been the need to bridge the gap betweenphysical and mental health. The NHS Five Year ForwardView for Mental Health1 emphasised the need for agreater focus on the psychological aspects of physical illness. Inkeeping with this, three of the articles in this issue focus on theintersection of physical and mental health, exploring thepsychological impacts of eating disorders, severe morningsickness and breast cancer.Although many of us will have no formal training in workingwith eating disorders, we may find ourselves with patientspresenting with other issues, who also suffer from anorexianervosa, bulimia or related disorders. In a frank exploration ofthis topic, eating disorder specialist, Kel O’Neill, challenges usto consider how we work with these clients. Huge increases inthe diagnosis of these disorders have led to long waiting times forspecialist services, which may increase the likelihood that thesepatients end up in the consulting rooms of those of us who are notspecialists. Kel highlights that, when working with these clients,we will often be working with life and death scenarios, and that wecannot afford complacency. Her article certainly challenged meto consider how I might improve my understanding of thepsychological impact of these disorders.One of the key ways in which we might challenge our work in thisarea is by bringing it to supervision. At its best, supervision givesus the opportunity to explore our blind spots and identify areasof growth. Michael Worrell considers whether the supervisionprovided to IAPT CBT practitioners is fit for purpose andsupports their needs. His reflections are not only relevant topractitioners of that modality, however. He highlights how goodsupervision provides the supervisee with a safe space to explorethe emotional complexities of working as a therapist. Havingrecently completed my own training as a supervisor, I found hisreflections helpful and pertinent to my future work in this area.Returning to the interplay between physical and mental health,Carol Morgan presents a case study of her work with a womanwho has suffered from breast cancer. She focuses on the positivepersonal growth in the women she has worked with through thecharity Breast Cancer Haven. This organisation seems to providean excellent example of responding to the needs of the wholeperson, adopting a holistic and individualised approach, andoffering complementary therapies alongside counselling.At its best, supervision givesus the opportunity to exploreour blind spots and identifyareas of growth
3CONTENTSThis need to respond to the whole person is also evident inMichelle Nicholson’s article on the psychological impact of severemorning sickness. Michelle’s first-hand experience of this issueled her to conduct research into how other women had coped andbeen supported through their physical and mental distress.Michelle and the women she interviewed shared the experiencethat, while healthcare professionals took care of their physicalneeds during their pregnancies, measuring bumps and bloodpressure, they were not asked about their emotional needs.Michelle sensitively captures the experiences of the 10 womenshe interviewed. These are useful reflections to bear in mind,should we find ourselves working with clients suffering fromthis condition.It is important to us that we ensure that this journal reflectsyour needs and interests. If you have any ideas for differenttypes of content that you would like to see in the journal, such asinterviews with therapists, or discussions of ethical dilemmas,then do please let me know.REFERENCE1 Independent Mental Health Task Force to the NHS in England. Five year forwardview for mental health. [Online.] 2016. d 29 November 2017).FEATURESEATING DISORDERS: IS INACTIONTANTAMOUNT TO NEGLIGENCE? Kel O’Neill argues that counsellors andpsychotherapists need to do more to recogniseand address eating disordersSUPERVISION AND TRAININGSUPERVISORS FOR IAPT: ARE WEGETTING THE BALANCE RIGHT? Michael Worrell explores whether the provision ofsupervision for IAPT CBT practitioners is adequateand fit for purposeTENDING THE GROWING EDGE:COUNSELLING WOMEN FOLLOWINGBREAST CANCER Carol Morgan explores the role of counselling infacilitating post-traumatic growthHYPEREMESIS GRAVIDARUM:WHO CARES? 08131824Michelle Nicholson reflects on the experiences ofwomen who have suffered the psychological effectsof severe pregnancy sicknessJoanna Benfield, Editorhcpj.editorial@bacp.co.ukREGULARSFROM THE EDITORNEWS AND RESEARCHCHAIR’S REPORT – BACP HEALTHCARE:Satinder PanesarHEALTHCARE UPDATE:Judy StaffordCOUNSELLING IN PRIMARY CARE:Elaine DaviesREVIEWSBACP HEALTHCARE ROUND-UP02040607283031
4NEWS & RESEARCH HEALTHCARE Counselling and Psychotherapy JournalJanuary 2018NEWS & RESEARCHNHS consultationon mental healthservices for childrenand young peopleIn December 2016, the Governmentpublished a Green Paper on transformingchildren and young people’s mental healthprovision. The proposals in the GreenPaper include the creation of newcommunity-based mental health supportteams, designed to improve co-ordinationbetween schools and the NHS. The teamswill provide early intervention treatmentin or near schools and colleges. Severalthousand people will be recruited to theseteams over the next five years, and will beprovided with training in CBT and otherevidence-based therapies. Additionalproposals include the designation of amental health lead in every school andcollege, and the piloting of a maximumfour-week waiting time for children andyoung people’s mental health services insome areas. Over 300 million of fundingwill be made available to support themeasures. A consultation on the proposalsset out in the Green Paper is open until2 March 2018. The consultation documentscan be found here: ision-a-green-paperSource: BACPREFERENCEDepartment of Health and Department for Education.Transforming children and young people’s mental healthprovision: a green paper. [Online.] Crown copyright; uploads/attachment data/file/664409/Transformingchildren and young people s mental healthprovision.pdf (accessed 5 December 2017).New NHS onlinetools to safeguardmental healthpatients at riskof radicalisationNHS England has produced newguidance for providers of NHS mentalhealth services to assist them in carryingout their statutory and professionalresponsibilities to safeguard children,young people and vulnerable adults whoare at risk of radicalisation. The guidancefocuses on the Government’s Preventstrategy, which is aimed at preventingpeople from becoming terrorists orsupporting terrorism. The guidancecovers four key areas: (i) responsibilitiesof mental health providers; (ii) Preventreferrals from mental health providers;(iii) the role of mental health providers inthe Prevent process; and (iv) referralsfrom Prevent to mental health services.The document sets out the safeguardingpathways that need to be in place and thetraining requirements for mental healthprofessionals, and also covers issues suchas working in partnership with the police.The guidance is accompanied by a newe-learning package, which includesreal-life case studies.Source: NHS England. NHS England Prevent mentalhealth guidance and new e-learning package nowavailable. 2 November 2017. [Online.] age-nowavailable/ (accessed 3 December 2017).REFERENCENHS England. Guidance for mental health servicesin exercising duties to safeguard people from therisk of radicalisation. [Online.] NHS England; ed 3 December 2017).HM Government. Introductory e-Learning trainingon Prevent. [Online.] HM Government; uk/mentalhealth (accessed 3 December 2017).PREVALENCE OFDEPRESSION INENGLANDA report published by NHS Digitalin November 2017 indicated that9.1 per cent of patients visiting GPssurgeries in 2016–2017 presented withdepression. The area with the highestprevalence of depression was Lancashireand South Cumbria, while the area withthe lowest prevalence was London.The Quality and outcomes framework –prevalence, achievements and exceptionsreport is an annual report that focuseson 21 commonly occurring medicalconditions, including asthma,hypertension, dementia and diabetes.It measures the prevalence with whichpatients present with these conditionsat GP surgeries. The report found that, in2016–2017, depression was the third mostprevalent of all the conditions measured,with only hypertension (13.8 per cent)and obesity (9.7 per cent) having higherprevalence rates. Depression also showedthe highest increase in prevalence(0.8 per cent) since the previous year, ofall the conditions measured. The report isbased on data provided by over 95 per centof GP surgeries in England.Source: NHS DigitalREFERENCENHS Digital. Quality and outcomes framework –prevalence, achievements and exceptions report.[Online.] Government Statistical Service; ssed 14 November 2017).
NEWS & RESEARCHPerinatal mentalhealth in WalesOlder adults andmental healthIn October 2017, the Children, YoungPeople and Education Committee of theNational Assembly for Wales published areport on perinatal mental health in Wales.BACP had lobbied the Welsh Assembly forthe re-establishment of a specialist mentalhealth unit for mothers and babies. TheCommittee took up this recommendationin this report, urging the Welsh Assemblyto re-establish the unit as a matter ofurgency. The Welsh Assembly has nowmade a budget available for this purpose.According to a survey conducted byAge UK, nearly half of adults over the ageof 55 in the UK have experienced mentalhealth problems. Age UK commissionedYougov to carry out the survey, whichfound that 7.7 million people over theage of 55 suffer from depression, with7.3 million suffering from anxiety. Themost common triggers for mental healthproblems included the death of lovedones, ill health and financial worries.Over one third of those who weresurveyed said that they did not knowwhere to go for help and support. A thirdsaid that counselling and talking therapywould help those suffering from mentalhealth problems, while nearly threequarters of respondents felt that helpingpeople to connect with others and tackleloneliness and isolation was the best wayto alleviate these problems.The report highlights that up to one in fivewomen is affected by perinatal metal healthissues; 12 per cent experience depression,13 per cent experience anxiety, and 15–20per cent experience depression and anxietyin the first year after giving birth. Thereport estimates that post-partumpsychosis affects one or two women perthousand; 50 per cent of these have noprevious history of mental illness.The report underlines the important roleof third sector organisations in supportingwomen suffering from perinatal mentalhealth issues. It highlights the needfor more funding to be provided forthese services.The Committee also focuses on theimportance of attachment in early life,and asks the Welsh Government to explorewhether specialist heath visitors can beemployed to support the mother-infantbond, as has been done in England. Thecommittee also calls upon the WelshGovernment to undertake an awarenessraising campaign to ensure that healthcareprofessionals understand perinatal mentalhealth conditions and their symptoms.Source: BACPREFERENCENational Assembly for Wales, Children Young Peopleand Education Committee. Perinatal mental health inWales. [Online.] National Assembly for Wales; -ld11234/cr-ld11234-e.pdf (accessed 14 November 2017).In September last year, the NHSpublished guidance on mental healthand older people, aimed at helping GPsto spot when symptoms often attributedto ageing are in fact signs of mentalhealth problems and therefore requirereferrals. Age UK and NHS England areworking together to raise awarenessamong GPs of the warning signs and toencourage older people to access mentalhealth services.Source: NHS England.REFERENCENHS England. Half of adults aged 55 and over haveexperienced common mental health problems, say AgeUK. [Online.] NHS England; 2017. lth-problems-sayage-uk/ (accessed 3 December 2017).NHS England. A practice primer on mentalhealth in older people. [Online.] NHS England; ssed 3 December 2017).5THE LINKBETWEENPERFECTIONISMAND SUICIDEA team from the University of Ontariohas been exploring the links betweensuicide and perfectionism. They carriedout a meta-analysis, studying 45 previousstudies on this topic, with nearly 12,000participants in total.There is no single agreed definition ofperfectionism, with the studies covering15 different ways of defining the concept.The researchers found that 13 of thesewere correlated with a likelihood ofhaving suicidal thoughts. Suicidalattempts were particularly prevalent inthose cases in which perfectionism wasrelated to trying to meet the expectationsof other people. However, having highstandards for others, and being tidy andorganised to a high standard, were notrelated to suicidal ideation.Six of the studies included in this researchwere seen as being particularly importantbecause they examined data over a periodof time, and were able to show that theperfectionist tendencies preceded thesuicidal thoughts or behaviours. Theresearch, which was published in theJournal of Personality, highlighted theneed for more longitudinal studies inorder to corroborate these findings.Source: BPSREFERENCESmith M, Sherry S, Chen S, Saklofske D, Mushquash C,Flett G, Hewitt P. The perniciousness of perfectionism:a meta-analytic review of the perfectionism-suiciderelationship. [Online.] Journal of Personality py.12333/abstract?campaign wolacceptedarticle (accessed 29November 2017).
6CHAIR’S REPORT HEALTHCARE Counselling and Psychotherapy JournalJanuary 2018ANTIDEPRESSANT USAGE:A SURPRISE INCREASE?SATINDER PANESARBACP AGMHappy New Year to everyone, and welcometo 2018! I would like to begin by reflectingon the BACP AGM that was held inBirmingham in November. This eventwas a useful opportunity for membersand everyone who supports BACP in avoluntary capacity to hear about the workof the organisation. It was a valuable day,and I enjoyed the opportunity to hear aboutthe good work that BACP is doing. Therereally is a lot of positive change happening.The day started off with presentationsfrom all of the divisions, as well as fromvolunteers from the board, organisers ofthe network meetings, representatives offinance and policy, and the Counsellingand Psychotherapy Research (CPR) journaleditorial board. I then attended a workshopon ‘A four Nations Approach’, which wasfacilitated by Steve Mulligan, BACP FourNations Policy and Engagement Lead.I found it useful to hear about the workthat is happening in Scotland, as well asthe other nations, particularly in terms offorming key relationships and improvingthe visibility of BACP across thepolitical environment. as I thought aboutmy current case load,I realised that around90 per cent of my clientswere on antidepressantsANTIDEPRESSANT USAGEIn the last issue of this journal, I wassurprised to read about the recent risein the prescription of antidepressants.A report published by NHS Digitalrevealed that there was a greater increasein the prescription of antidepressantsthan any other drug dispensed in thecommunity in England in 2016.1As I reflected upon my response, I realisedthat my shock was not really at the factspresented, but rather at seeing themwritten down in black and white. In fact,as I thought about my current caseload,I realised that around 90 per cent of myclients were on antidepressants. Thisrealisation made me feel very sad.I’m aware that the figures in the NHSreport are for England. However, I’m surethat they wouldn’t be much different forScotland, North
and South Cumbria, while the area with the lowest prevalence was London. The Quality and outcomes framework – prevalence, achievements and exceptions report is an annual report that focuses on 21 commonly occurring medical conditions, including asthma, hypertension, dementia and diabetes. It measures the prevalence with which
counselling and psychotherapy by becoming the British Association for Counselling and Psychotherapy. In 1998, the Psychotherapy & Counselling Federation of Australia was established. Nevertheless, some people such as Corsini (2008) try to distinguish counsel-ling from psychotherapy. For instance, psychotherapists may be more thor-
Unit 8: Continuing Personal Development in Counselling 57 Unit 9: Human Development in Relation to Counselling 63 Unit 10: Client Work in Therapeutic Counselling 69 Unit 11: Counselling for Loss and Grief 75 Unit 12: Counselling Clients Who Have Experienced Abuse 81 Unit 13: Counselling Young People 87 Unit 14: Relationship Counselling 93
The Code of Ethics for the Canadian Counselling and Psychotherapy Association is a living document. Between revisions to the Code, feedback from members is accepted and compiled in preparation for reviews, updates, additions, and amendments. The Revision Process Approximately every five years, the Canadian Counselling and Psychotherapy
research on counselling and psychotherapy explicitly focused upon the prevention of suicide, considers studies of counselling and psychotherapy for people who deliberately self-harm. The review does not limit itself to the consideration of randomised controlled trials, but also includes non-randomised trials, and other quasi-experimental and non-
Good Practice across the Counselling Professions 004 3 What works in counselling and psychotherapy relationships Context 5 Using Good Practice across the Counselling Professions resources 5 Introduction 6 1 Current landscape 6 2 Research 7 3 The therapeutic relationship 8 3.1 Client factors
a variety of therapeutic models is provided in our books Practical Counselling Skills (Geldard and Geldard, 2005, available in the UK and Europe) and Basic Personal Counselling (Geldard and Geldard, 2012, available in Australia and New Zealand). Counselling young people involves different demands from those encountered when counselling adults. By making use of a very wide range of counselling .
Counselling Card 4. Importance of exclusive breastfeeding during the first 6 months Counselling Card 5. Breastfeed on demand, both day and night (8 to 12 times) to build up your breast milk supply Counselling Card 6. Breastfeeding Positions Counselling Card 7. Good Attachment Counselling Card 8. Feeding a low birth weight baby Counselling Card 9.
Counselling is used in a variety of situations: psychological counselling, career counselling, legal counselling, etc., and has to do with engaging and assisting people facing a specific problem, to solve the problem or identify the acceptable coping mechanism. Despite there is not a single definition of "counselling",
