The Trainee Handbook

A Guide for Counselling & Psychotherapy Trainees

Robert Bor, Mary Watts, Robert Bor, Mary Watts

• Publisher: SAGE Publications Ltd
• Year: 2016
• ISBN:
  9781473998223
• Edition: 4
• Topic: Psicología
• Subtopic: Formación en psicología

Written by a team of leading trainers, practitioners and supervisors, this bestselling classic is the trainee therapist's best friend. It identifies and guides trainees through the practical skills and knowledge they?ll need to make a success of their training - from writing essays through to case formulation and on to preparing for their first meeting with a client. Along the way, it addresses and allays the concerns which are common to all students.

Now in its fourth edition, the book has been fully updated to take account of the significant changes in the therapy professions in recent years. It now includes new and important chapters on:

• Evidence-based practice
• Working with diversity
• Reflective practice
• Using social media, technology and online therapy

The Trainee Handbook is an invaluable companion, and source of information and guidance for all trainees in counselling, psychotherapy and counselling psychology, and newly-qualified therapists entering into practice.

1 Setting the scene

Sheelagh Strawbridge

Introduction

If you are reading this book, it is likely that you are thinking about or beginning training in counselling, psychotherapy or counselling psychology. You may be a little bewildered by the range of trainings, approaches and labels attached to the work. Your own choice of training might relate to what is available, accessible and affordable or you might be able to invest in an approach that you are passionate about. You may well feel a strong pull towards a particular training route but find yourself disappointed, being unable to access it, and you may have concerns about employment opportunities. Whatever your position, your interests, motivations, attitudes, values and degree of commitment will all affect your approach to training, what you put into it and what you get out of it.

I think it is important to start here because you are entering a rather strange world. It is even difficult to know how to refer to it as each identifying term raises questions and disparate approaches and histories are encountered in an arena of conflict around issues of professionalization, regulation and an increasing association with health and medicine. This is not surprising as the process of professionalization, whatever the developing profession, involves passionate feelings and strongly conflicting interests. There is a lot at stake and the shape our profession adopts will affect the lives, livelihoods and status of many people both on the receiving and the practising end of services. Nevertheless, while the world you are entering is confusing, it is also exciting and offers the opportunity to be actively involved in shaping its future.

It is therefore worth spending some time exploring what it means for our range of practices to claim professional status and for a person to enter that profession. In the current climate in the UK the implications of regulation, entry-level thresholds, the monitoring of standards, National Institute for Clinical Excellence (NICE) guidelines and changing contexts of employment all have a bearing on these questions. Moreover, what is at issue in the UK has wider relevance as fundamental disagreements concerning the defining characteristics of practice are brought into focus. Here and in the final chapter I invite you to begin to explore these questions and suggest some theoretical maps to aid you.

The issues are complex and understanding them a challenge. Nevertheless, you will encounter them during the course of your training and your professional life, so it is useful to get some sense of what is involved right from the start. You will then have a foundation on which to base further consideration as the issues come to life in your own experience. It is important to remember that both this and the final chapter offer my own perspective and contribute to an ongoing debate. There are no definitive answers but debate is a vital element in clarifying thinking. I hope that you will engage in this and consider your personal views, attitudes and values, and their implications for you both as an individual practitioner and as a member of a professional community.

Here I shall refer to our profession as ‘psychological therapy’, because the alleviation of psychological distress and the development of self-understanding and personal growth, defined in broadly psychological terms, are its widely accepted aims. Nevertheless, even to call it psychological therapy, to distinguish it from more physical therapies, is problematic because some approaches define themselves as philosophical rather than psychological, our physical bodies and ‘body work’ are central in others, there is a range of arts psychotherapies, and counselling and coaching share aims and approaches in some arenas of practice.

This begs the question as to whether there is a single identifiable profession. There may be more significant differences between theoretical approaches within rather than between professional groupings, and Pilgrim (1997: 113) notes that, although ‘psychotherapy’ can produce strong subjective identities in practitioners, it fails to denote a coherent professional group or discipline. Indeed, the disparate origins of our practices and professional organizations can be linked to current conflicts. It is also worth remembering that, while the focus of this book is on training in psychotherapy, counselling or counselling psychology, psychoanalysis (a grandparent of these diverse tribes) sits at some distance and maintains an ambivalent attitude towards them.

Notwithstanding the influence of psychoanalysis and movements in critical psychiatry, within the mental health services there are historical connections between psychotherapy, clinical psychology and psychiatry that confer status and a bias towards a biomedical perspective. Counselling, however, largely developed separately, with connections to human potential and self-help movements as well as voluntary services. These tended to hold critical views of mental health provision. So regardless of similarities in practice and client populations there can be a tension between top-down profession and bottom-up user-oriented roots that relates to the struggle by counselling to claim equal status with psychotherapy and psychology and, in the context of regulation, develop equivalent entry-level thresholds. So Counselling Psychology, a Division of The British Psychological Society (BPS), is included within psychology and regulated by the Health and Care Professions Council (HCPC) with a doctoral-level threshold. The British Association for Counselling and Psychotherapy (BACP) has an entry-level Register and a further level of Accreditation, with independently defined professional standards. The United Kingdom Council for Psychotherapy (UKCP) registers practitioners accredited by its Organizational Members and The Independent Practitioners Network offers a principled opposition to formal regulation based on peer group membership. All this has implications for status, salaries and employment. Furthermore, the UK government-backed initiative ‘Improving Access to Psychological Therapies’ (IAPT) both threatens traditional trainings and accreditations and offers alternatives.

It will not be possible in these short chapters to unpick all of this but I think it will be useful to start by focusing on what it means to claim professional status and on issues peculiar to a profession of ‘psychological therapy’.

What is a Profession?

The word ‘profession’ has a range of meanings and uses interestingly explored by Hammersley (2009). Moreover, in distinguishing professional from amateur and voluntary professional often implies paid and amateur is sometimes used to denigrate performance, though amateur and voluntary work is often highly professional. So I think it will be useful to recognize that some distinctions can be drawn between ‘professionalism’, with respect to competence, standards and the quality of work, ‘professions’, as specific groups, and ‘professionalization’, in relation to formal claims to status and processes such as regulation.

For now it will serve to note that to assert professional status involves claiming competence in specialized knowledge and skills. In our case the basis of this claim is often, though not always, psychology. Tjeltveit, for example, states, ‘When psychotherapists assert that they are professionals, they announce, … that they possess specialized knowledge and technical skills that help people with psychological problems’ (1999: 255). Of course, how psychological knowledge, skills and problems are defined and who is qualified to claim psychological expertise are the basis of much controversy. There are similarities with the historical power struggles that legitimated what became mainstream medicine and, of course, other practices, often termed ‘complementary’, exist and also claim legitimacy.

The nature of professions and their role in society is a significant area of sociological inquiry worthy of more attention than is possible here (Macdonald, 1995, provides a good introduction). It is also worth considering the political critiques of professional power seen from varying perspectives either as an agency of social control or disabling the capacity of individuals to care for themselves (Strawbridge, 1999, and see, for example, the writings of Michel Foucault and Ivan Illich). Let it suffice here to note that power struggles characterize the process of professionalization and, according to trait theories, emerging professions have always sought to monopolize forms of expertise and erect social boundaries around themselves. When established, they control entry through lengthy training and qualifications (Abbott and Meerabeau, 1998: 3). Regulation gained by some sections of our profession and s...