Counselling and Psychotherapy

I am frequently asked by clients what the difference is between counselling and psychotherapy. Having completed training in both counselling and psychotherapy, I can speak from experience when explaining some of the differences.
Counselling and psychotherapy are interchangeable, that is to say they overlap in several ways. Some might argue that the key difference is the longevity of the work between client and therapist; so the number of sessions the client and therapist meet for. I would argue that whilst this is potentially one factor, it is possible to complete brief therapeutic work with clients both as a psychotherapist and counsellor. In fact one of the requirements for my training and qualification as a psychotherapist is proven work with clients which includes both short and long term therapy.

counselling

Thinking about requirements for training, this is an important factor that underpins the type of work a counsellor or psychotherapist can offer. There are two main governing bodies for counsellors and psychotherapists in the United Kingdom. These are the British Association for Counselling and Psychotherapy (BACP) and The United Kingdom Council for Psychotherapy (UKCP.) Whilst there are no rules stipulating who can and cannot call themselves a counsellor or psychotherapist, counsellors and psychotherapists that are registered with either the BACP or UKCP have completed a specific level of training as part of an accredited course which enables them to gain registration with either the BACP or UKCP. This is important for anyone looking for support from a counsellor or psychotherapist. Always look to see if the person claiming to be a counsellor or psychotherapist is registered with either the BACP or UKCP or that they are in the process of completing a level of training that enables them to do so.
To register with the BACP a person must have completed a counselling or psychotherapy course that is a minimum of one year full time or two years part time with a supervised placement that is a minimum of one hundred hours. A supervised placement is where a counsellor or psychotherapist receives supervision for the therapeutic work they undertake with clients. All counsellors and psychotherapists receive supervision throughout their career as a counsellor or psychotherapist however the amount of supervision required varies depending on the stage they are at in their career. The BACP requires a counsellor or psychotherapist to receive one hour of supervision for every eight hours of client work undertaken in their initial one hundred hour placement.
Training is longer and more rigorous for counsellors and psychotherapists that are registered with the UKCP. The usual requirement is the completion of a Masters Level course in psychotherapy or an accredited course in psychotherapeutic counselling. To train as a psychotherapist leading to UKCP registration takes a minimum of four years followed by a minimum of two years of practice under supervision, usually weekly, for every six hours of work undertaken with clients, and usually for the first four hundred and fifty hours of work with clients. Likewise, UKCP membership as a psychotherapeutic counsellor requires evidence of four hundred and fifty hours of practice; theory and skills.
Another contributing factor which determines registration is whether a psychotherapist or counsellor has embarked on their own journey of personal therapy. To register with the BACP it is not a requirement that the counsellor or psychotherapist has undertaken their own personal therapy. To register with the UKCP a counsellor or psychotherapist must have received their own personal therapy usually for a minimum of once a week for fifty minutes throughout the duration of their training.
therapy
So, what does this mean to the actual work of counsellors and psychotherapists? As mentioned previously there are many overlaps in the type of support that is available from a counsellor and psychotherapist. I would summarise the main differences as consisting of the following:

  • Counsellors have an understanding of theories and research on mental health and well-being and what can contribute to obstacles to a person’s wellbeing. They can use this to facilitate client development.
  • Counsellors have an understanding of theory and research concerning specific life problems, issues and transitions that commonly lead to people considering counselling and are able to use this to inform their work with clients.

In addition to the above:

  • Psychotherapists have an understanding of typical presentations of severe mental disorder.
  • Psychotherapists understand methods of diagnosis of severe mental disorder appropriate to a theoretical approach and are able to conduct appropriate diagnostic procedures.
  • Psychotherapists understand and are able to implement treatment methods to address symptoms and causes of severe mental disorder.

Different people use the words counselling and psychotherapy in varying ways. There is a general understanding that a psychotherapist can work with a wider range of clients and can offer more in-depth work where appropriate. Such in-depth work can include drawing on a clients thought processes and way of being in the world in order to help in regards to specific problems and to help the individual to gain greater self awareness. Part of the process often entails examining feelings, actions and thoughts and learning how to evaluate and adjust behaviour if and where appropriate. It can frequently lead to long term change for the client. Psychotherapy can help a person to deal with psychological difficulties that have developed over a long period of time, helping to identify the emotional issues and background to difficulties.
Counselling can help a person to explore their personal development and create helpful adjustments in their life. Counselling can help a person to identify problems and crises and support the individual to take positive steps to resolve issues and change problematic behaviour. It is frequently a shorter term process to psychotherapy.
Psychotherapeutic counsellors are counsellors who have received a more in-depth level of training than that undertaken by most counsellors.
In actual practice a psychotherapist may provide counselling to support an individual with specific situations and, as mentioned above, a counsellor may function in a psychotherapeutic manner. However, whilst a psychotherapist is qualified to provide counselling, a counsellor may not possess the necessary training and skills to provide psychotherapy. This can be helpful to know as even in counselling, the need for a deeper level of work may become apparent in which case more psychotherapeutic work might be necessary. Whenever considering having counselling or psychotherapy with someone, always consider the persons training and qualifications, background and work experience as well the ethical guidelines governing their work.

References and further reading:
Counselor or Psychotherapist? The Difference between Counseling and Psychotherapy
By Nancy Schimelpfening,
Updated January 30, 2013
http://depression.about.com/od/psychotherapy/a/counseling.htm

UKCP – United Kingdom Council for Psychotherapy
Psychotherapy
http://www.psychotherapy.org.uk/article140.html

UKCP – United Kingdom Council for Psychotherapy
Training Basics
http://www.psychotherapy.org.uk/iqs/dbitemid.146/sfa.view/students_and_trainee_therapists_frequently_asked_questions.html

The Difference between Counselling and Psychotherapy
By Anna Martin,
Updated June 29, 2013
http://www.thecounsellorsguide.co.uk/difference-between-counselling-psychotherapy.html

BACP – British Association for Counselling and Psychotherapy
BACP Student Pages
http://www.bacp.co.uk/student/faq.php

HCPC – Health and Care Professions Council
Consultation on the statutory regulation of psychotherapists and counsellors
http://www.hpc-uk.org/aboutus/consultations/index.asp?id=93

Jayne Life

Didsbury and Chorlton

This week saw the launch of another Didsbury Arts Festival. The event boasts a range of artists and talent from across the arts and always proves a success with local residents and visitors. This is the events fifth year, bringing together local, national and international artists. From poetry at Didsbury Library, a historical walk around Didsbury hosted by New Manchester Walks to live music at Didsbury Perk, the event has something for everyone whatever age. One of the things I love about Didsbury is the sense of community. Events such as the Didsbury Arts Festival really help to bring people together to take advantage and enjoy what the area has to offer.

Didsbury has a vibrant mix of independent shops, bars, eateries, tea rooms, boutiques, furniture and gift shops to name a few of its attractions, as well as plentiful green spaces such as Fletcher Moss Park and Marie Louise Gardens. I have to agree with people who say there is something for everyone. I recently took part in a discussion about what it means to have a sense of self and social identity. Something I have picked up since becoming part of Didsbury’s community is people’s allegiance to the area and how many people speak proudly of Didsbury being part of their identity.

Equally, in regards to Chorlton, I’ve enjoyed the eclectic mix of talent that an area such as Beech Road attracts. From galleries such as The House of Bystander which hosts Jack Lloyd’s photography to On the Corner’s super power juices and selection of vinyls, I love visiting Chorlton’s Beech Road and immersing myself in the vibrancy. Despite Chorlton not being a million miles away from Didsbury, I didn’t visit as frequently as I would have liked outside of my time spent at my Chorlton therapy room. Aside from driving, public transport links between Didsbury and Chorlton were not regarded by many residents as being the best. With the arrival of the Metrolink to Didsbury, there is ample opportunity to travel from any one of the Didsbury Metrolink Stations in East Didsbury, Didsbury Village, West Didsbury and Burton Road, to Chorlton. Having viewed some of the upcoming events in Chorlton, they strike me as having a holistic feel. From Zumba to meditation workshops and comedy, Chorlton strikes me as being conscious of offering attractions that also aim to take care of a person’s physical and emotional wellbeing as well as their mental health. I’m thankful that I can be a part of that by providing support through counselling and psychotherapy. Being affiliated to Counselling Rooms on High Lane, enables me to be part of a Community Interest Company, providing private counselling and psychotherapy at reduced rates to members of the community who might be struggling during difficult financial times.

Both Didsbury and Chorlton pride themselves on fostering the success of independent local businesses. Certainly in my experience of Didsbury residents, they have held strong views against allowing chain stores to open on Burton Road in West Didsbury, preferring to retain its identity and reputation of consisting primarily of independent businesses. Thinking back to the discussion I took part in recently on personal and social identity, we could argue that Didsbury and Chorlton encourage both. They promote the success of independence amongst residents; supporting and nurturing individuals to grow their business and feel successful, where independence and uniqueness is encouraged and celebrated. This in turn appears to evoke in individual residents a sense of belonging to a larger group; a community which has an identity of its own.

Jayne Life

Sleep and Mental Health and Wellbeing

We could argue that sleep plays a massive part in our lives.  Many people refer to sleep as helping a person to ‘recharge their batteries’ and recuperate.  Others argue that it is important in enabling us to remain physically fit and healthy.  Some people claim to be able to function during their waking day on as little as four hours sleep a night, whilst others insist they can only manage after eight hours sleep.   For some people who suffer with insomnia, sleep can feel like an ongoing battle.  I recently took part in a discussion about sleep; its benefits, why it is important for a healthy body and mind, whether more sleep or the quality of sleep bears any impact on our functioning during our waking day and what determines a ‘good night’s sleep.’

One thing that I think about is how much control we each have over the amount and quality of sleep we get.  For many of us, deadlines for projects with work can mean late nights working and early starts to pick up where we left off.  I and others I know have at times worked through the night to complete projects, very much avoiding sleep and keeping ourselves awake on caffeine and sugar.  Reflecting on such experiences helps me to realise that it is the exact opposite to what health professionals would argue contributes to a healthy body and mind.  I’m sure we could all identify some of what constitutes a healthy lifestyle – a balanced diet consisting of fresh foods that are good for us, drinking lots of water, low caffeine and alcohol intake, exercise and sleep.  Yet, how many of us find it easy to do this.  I wonder that for us all to succeed in following a programme for a healthy lifestyle that includes getting a good night’s sleep, whether this will only work if there is a shared belief amongst all of us that this is something important and necessary to help people to feel happy and healthy.  Or else, how easy is it to turn around to our boss when they give us a piece of work late in the afternoon and tell us it needs to be completed by nine AM the next day and say ‘sorry, this is unrealistic.  I am contracted to finish work in two hours and this piece of work will take me at least five hours to complete.  Once I have gone to my one hour yoga class, cooked my fresh healthy meal, had my bath with relaxing lavender oils to help me unwind and gone to bed by ten o’clock to ensure I get eight hours sleep for optimal performance tomorrow, I simply won’t have time to do the work and therefore won’t be able to meet the deadline.’

Thinking about such a scenario it feels like a vicious cycle.  So many of us accept unrealistic deadlines with work and being pushed to work beyond our contracted hours that we could argue we neglect our wellbeing in the process.  We work late, eating convenience foods to save us time so we can work more, which is at the expense of sleep.  The more we continue to do this, the more acceptable we make it and the more tired we become.

This leads to me to think about the quality of sleep we get.  I have heard it said that alcohol induced sleep is not ‘proper sleep’ and can leave a person feeling more tired afterwards.  I know that if I am feeling very busy and have lots on my mind, then I can struggle to sometimes get to sleep even if I am tired.  Sleep during these periods can also feel filled with dreams.  At times when I am incredibly tired, I seem to fall asleep so easily and enter into a very deep sleep where, if I have dreamt, I can’t recall the dreams.  Perhaps dreams hold a clue to how calm or stressed we feel during the day.  I know I’ve certainly spotted a pattern that if I’m not as relaxed and my head feels filled with the business of my day, then I wake feeling tired and being able to remember my dreams.  When I’m feeling calm and less busy, then I sleep deeply, awake feeling refreshed and I don’t remember my dreams.

I can’t help but wonder that unless we all see sleep as important, many people will continue to be without sleep and feel that the amount and quality of sleep they get is out of their control.

You can view further thoughts and comments from myself and others who took part in a discussion on sleep and mental health and wellbeing at:

http://storify.com/MHChat/sleep-and-mental-health-wellbeing?utm_source=t.co&utm_content=storify-pingback&utm_medium=sfy.co-twitter&utm_campaign=&awesm=sfy.co_hIHy

A discussion on dreams and mental health and wellbeing can also be found at:

http://storify.com/MHChat/dreams-mental-health-and-wellbeing?utm_medium=sfy.co-twitter&utm_campaign=&utm_content=storify-pingback&utm_source=t.co&awesm=sfy.co_fIcK

Thanks to Mental Health Chat for hosting such interesting debates.  Find Mental Health Chat on Twitter at @MHChat

Jayne Life

Some Thoughts on Bullying

Having recently taken part in a discussion about bullying and its effects, hosted by ‘Mental Health Chat’ I was keen to share and elaborate on some of the main points from the discussion.

There appeared to be a shared understanding that bullying can take many forms, and can exist for both adults and children.  A common theme of what bullying actually is, centred on a feeling of exclusion.  This idea of exclusion is one that interests me and when asked to elaborate on how one might experience exclusion, there were a number of examples I could give.  The various examples perhaps highlight for us how bullying is not limited to childhood experiences.

What sprang to mind were some of the experiences people have shared with me over time and some personal memories as well.  I recalled when someone recounted to me being new to a workplace and working in a small, open plan office.  Emma had diligently got on with her work throughout her first week, hoping to impress.  On the first Friday after her first week of working there, everyone gathered their belongings and headed out for drinks at a local bar; everyone except Emma who no one thought to invite.  The very fact established members of the work team made arrangements for their evening out in the presence of Emma, without inviting her along, heightened her feeling of isolation and exclusion from the group.  Emma described feeling not wanted as no one appeared to want to invite her to join them for drinks.  Leaving work on her own as everyone else headed for drinks together, she felt depressed and alone.

Staying with work, I can recall a personal experience of joining an organisation which consisted of a great number of long standing members of staff.  All were very familiar with one another having worked as part of small teams for a significant number of years.  As part of my role I was required to manage one of the teams.  Introducing change can often be met with unrest from established members who have been used to a particular way of working.  It is one of the tasks as a manager to contain and manage members’ feelings around this.  However, what is common, somewhat ‘normal’ unrest and a period of ‘storming’ (Tuckman, 1965) soon became bullying; the aim of which was to obstruct and prevent change being made, and challenge my leadership of the group.  It is important to note here that challenge is fine.  It is how it is done and what exactly is challenged which differentiates the behaviour as bullying.  What I considered to be bullying was the ‘linking up’ of group members and a collusive ‘splitting off’ from me as part of the group.  This separate group persisted to criticise and challenge everything that I did with no reason as to why.  They abandoned their individual tasks resulting in an increased workload for me.  When I tried to address this with them they insulted me and accused me of lying claiming they had done the work that they had left.  They created stories about me which were untrue and which they shared with their colleagues in other teams who were also their friends.  As someone new to the organisation with no allies, I began to feel excluded and very much an outsider to the group.

These examples describe what some may regard as ‘mental’ or ‘emotional’ bullying.  There are also cases of more ‘physical’ bullying such as a group or ‘gang’ of school children that physically beat up and attack another young person.  We could argue that regardless of whether bullying exists in the form of what people say to another person or by someone or a group physically attacking another, the aim is to overpower and intimidate.  I would argue that it’s this overpowering and intimidation that can evoke feelings of exclusion and loneliness in a person.  In the above example of my experience of managing a group, I would argue their aim was to overpower me so that I wouldn’t introduce change; that instead I would give up trying to manage them and let them have their own way and allow them to manage me.

The longer the period of time a person is bullied, the longer lasting the effects can be.  Such long term effects can often include feelings of anxiety and depression in an individual.  An interesting point of view from some is that a person bullied is more likely to bully others.  Perhaps this is where help and support for a victim of bullying is so important in order to help an individual process what has happened and recover from the experience without exhibiting negative behaviours towards others.  This could be in the form of mentoring in school or through counselling or psychotherapy.  It is understandable why one might want to let others know what the painful experience of bullying was like by giving them a flavour of the experience themselves.  I have met many people who have said that through being bullied they made a conscious decision to be more assertive so as to try and avoid people thinking they can overpower and intimidate them.  We could argue that an effort to be more assertive is something positive to come out of the experience.  Anything positive that can come from a person’s experience of being bullied is surely a good thing, for the experience whether as a child or as an adult, can feel like a cruel existence; an existence that can feel so painful that at its most extreme has led people to take drastic action to end the suffering.

There is so much more that can be explored in regards to bullying.  Many questions have been looked at and continue to be revisited as bullying continues to exist in a growing number of forms such as cyber bullying.  Questions such as whether there are differences between how males bully and how females bully and whether it is more common among one sex compared to another.  Other questions focus on exploring the effects of bullying both short term and long term and how to tackle bullying, particularly in schools.

One thing we can probably be certain of is that bullying is unlikely to go away.  This in itself is a depressing thought.

*Consent has been used to use specific examples and names have been changed to protect identity.

 

References and further reading ‘The Four Stages of Group Development’ (Tuckman, 1965)

 

Find ‘Mental Health Chat’ on twitter at @MHchat

Jayne Life

Volume Control

Having worked in specialist schools for several years, I have been reflecting on how the needs of students are met within the classroom.  Over the years there has been much debate amongst educationalists as to what kind of class grouping works best for students; whether grouping should be based largely on the students’ ability or age.  However, on thinking about meeting the needs of students on the autistic spectrum, there is perhaps more to consider.  This article aims to discuss some of these considerations and provide food for thought for practitioners working in schools.

For young people at what might be referred to as the severe to moderate end of the autistic spectrum, there are many factors to take into consideration when placing them in a class.  Many students at this end of the spectrum, described as what many refer to as ‘classically autistic’ present with attributes that can be challenging for any class group.

I have worked with many students over the years who have experienced noise sensitivity yet have generated lots of noise themselves as a result of the nature of their autism.  Their noise has appeared to increase around one another in what has appeared an attempt to block out one another’s sounds.  Such noises have included the constant repetition of phrases and sounds which have frequently accompanied ‘flapping’ and what can be described as the re-enacting of footage and clips from favourite DVD’s and computer programmes.  As a practitioner I have at times found it difficult to try and teach a group of students who are generating so much noise as individuals yet are incredibly noise sensitive to the sounds of each other.  Many have struggled to tolerate one another, becoming distressed at one another’s sounds.  As an adult who isn’t autistic I have found the noise at times overwhelming, so for students who are acutely noise sensitive as part of their autism, the experience must feel unbearable.   Indeed, this may well be the case when I think about some of the behaviours that are exhibited; students lashing out at the member of staff working with them, cowering when they see a particular student who is particularly noisy, biting their hand in what looks like frustration and anger.  We could argue that they may be exhibiting such behaviours as a result of other triggers, yet it would appear from observing the behaviour of the students and their constant desire to hold their hands over their ears, that the noise is a major contributor.

So what is the solution?  Perhaps a more mixed class grouping is appropriate.  In mainstream schools it is uncommon for students to be grouped in mixed year groups.  Some primary and early years settings offer mixed groupings however once students reach secondary age it is unlikely one would find a group of year eleven students being taught in a group with year nine’s.  However, in special schools there is often scope to group students in a way which reflects a range of factors that are taken into consideration as opposed to simply age.

Autism represents a diverse spectrum of need.  It is this spectrum of behaviours and traits that I believe needs to be thought about with closer inspection.  Some questions to ask might include which students can tolerate being near to one another regardless of their academic ability?  Which students create a lot of noise and which don’t?  Which students are verbal?  If so, what is the extent of their functional language?  Which students enjoy interaction and contact with others?  It is important to note here that although there might be a stereotypical view of people with autism not wanting to engage with others, this is not true in my experience.  I have worked with plenty of young people with autism who have actively sought out contact with others, have been affectionate and have enjoyed interacting with another person.

On first thinking about how students should be grouped, it may seem an obvious choice to group several students together who are of a similar age and who present with a similar level of need and academic ability.  However, it would appear that this model results in some class groupings which offer a climate we might argue is conducive to learning, and groupings which offer the opposite.  Having worked in schools that have catered for students with a range of special needs and those which are designed specifically for students with autism, I have taught and seen a range of groupings; some have been very diverse and reflected a variety of needs and ages, others less so.  This has led me to draw my own conclusions as to what does and doesn’t work in creating an environment conducive to students learning and in particular students with autism.

Think of a large organisation or business.  There are many different roles that need to be filled, each with a different job description.  There may be similarities between roles and multiple positions however generally workplaces reflect a variety of personality types and talents.  There are extroverts, introverts, leaders and followers to name a few.  A team wouldn’t be conducive to succeeding at the task in hand if all the members had the same skills and personality type.  It’s a similar result when thinking of students learning in a classroom.  A group of noisy, noise sensitive students, who each need lots of individual support and attention, are not going to work well together in succeeding at achieving their individual targets and goals, particularly if there is a limited number of staff available to support them.  A group which contains quiet, and what some may regard as ‘high functioning’ autistic students, where sensory difficulties are less of an issue, are more likely to succeed.

So why not mix?  I have experienced teaching large groups of students with autism with a range of needs and abilities and with a limited number of staff.  The significant factors that contributed to the group working were as follows;

The majority of students were quiet and did not generate a lot of noise or flapping.

The majority of students were not noise sensitive and could tolerate the sounds and noises of some of the other students who were.

Students who made a lot of noise and flapped were in a minority.  Being in a group where the majority of students were quieter appeared to decrease the tendency to be noisy and flap in the students who did at times exhibit this type of behaviour.

Staff were more easily deployed as not every student required one to one support.  Students who did require support to help refocus them could have a member of staff working closely with them.  Students who were able to work alongside one another could be comfortably supported by one member of staff.

There was much differentiation required in the planning of lessons in order to engage each student and enable them to reach their individual learning goals.   However, students were able to sit close to one another whilst working on individual pieces of work.  The range of abilities also lent itself to small group activities and peer work.  Having a limited number of staff didn’t matter as students weren’t trying to drown out one another’s sounds through their own sounds nor were they attempting to silence one another through aggression.  Such behaviours have been apparent with smaller groups of students where the needs have been less diverse.

As mentioned earlier, this article is not intended to outline a set of criteria for what makes for a successful class grouping nor has it been written with the intent to criticise and blame in any way, schools and practitioners.  It is intended as food for thought based on my experience in the classroom.  That said, a group of students who are each noise sensitive yet very noisy themselves, struggle to tolerate one another and become aggressive, who have a limited number of staff working with them, is what we might call a recipe for disaster.

Jayne Life

A Short Introduction

Hi, I’m Jayne Life and welcome to my blog.  I’ll be posting various articles and commenting on matters in relation to special educational needs and psychotherapy.  For starters, check out my article on discussing noise sensitivity in children with autism titled ‘Volume Control’.  Also, earlier today I was interviewed about Pica – a condition that affects many children with autism.  You can watch the full interview on Granada Reports tonight at 6Pm on ITV.