Counsellor / Counselling


A Counsellor is usually taught a particular approach to therapy, such as person centred therapy, and then develops experience, under supervision, in the application of that approach.  Some Counsellors will have a depth of experience, but others may have had a short training and have only been practising for a few years.

In the 1990s I headed up a team of researchers investigating counselling in GP surgeries, evaluating the work of primary care counsellors with nearly 2000 clients.  The results were published in:

Evaluation of a primary care counselling service in Dorset.  Baker, R., Allen, H., Gibson, S., Newton, J., and Baker, E., British Journal of General Practice, March 1998 and A naturalistic longitudinal evaluation of counselling in primary care.  Baker, R., Baker, E., Allen, H., Golden, S., Thomas, P., Hollingbury, T., Newton, J., & Gibson, S.  Counselling Psychology Quarterly Vol 15, no. 4, 2002.

Both studies showed that primary care counselling was undoubtedly effective when compared with a waiting list control.  However, this was one of the few controlled trials of counselling.  The greatest number of controlled experimental research projects have been conducted with Cognitive Behaviour Therapy/CBT.  There is so much research showing the effectiveness of CBT that it has rather overshadowed counselling and the NHS Advisory bodies and NHS funding  has flowed towards this more ‘evidence based’ Cognitive Behaviour Therapy approach.

Person-centred counselling holds that the client-counsellor relationship as central.  The aim of the counsellor is to help the client explore their feelings and motivations with a view to finding their own answers and explanations.  Originally Carl Rogers called it ‘non-directive psychotherapy’ because the therapist’s aim is to reflect, not to advise.  Some people find this helpful, others prefer a more direct approach.  It is excellent for many emotional problems such as depression, but for something more specific, such as phobias or obsessive compulsive disorder, the much more direct CBT approach is preferable.

Personally I agree that the client-therapist relationship is central and helping the client to explore issues is so valuable, but I would integrate this with more direct approaches such as cognitive behaviour therapy or emotion focussed therapy, depending on the individual case.

Unfortunately there are many specific types of counselling or therapy advertised which are without any scientific foundation, bordering on the weird, esoteric or making excessive claims with therapists who do not have clinical experience.  For most people it is hard to judge the genuine from the exaggerated.  Probably the best guide is whether the counsellor is accredited with a major clinical body, such as: Health and Care Professions Council, British Psychological Society, British Association for Counselling and Psychotherapy , United Kingdom Council for Psychotherapy , and the British Association for Behavioural and Cognitive Psychotherapy.