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A conceptual framework rooted in existentialism is presented to unify psychological and sociopolitical perspectives. Human beings are directional, with well‐being the actualization of highest order directions. Distress emerges through external blocking of directions, or through dysergetic or ineffective internal configurations. Hence, social justice work and counseling have essential, and integrated, roles. [ABSTRACT FROM AUTHOR]

The multivoicedness of the self has become an important theoretical concept that is influencing modern psychotherapy research, with consensus that individuals should be studied within their social contexts. However, there are few qualitative tools that can help to develop in-depth, "thick" understandings of this multivoicedness. The qualitative method for analyzing multivoicedness (QUAM) is an innovative, systematic research tool for analyzing internal I-positions, external I-positions, and their interactions. QUAM was developed within a social psychological context, and in this article we consider its applicability to the psychotherapy research field. Transcripts from the first, 12th, and 24th (final) therapy sessions in a single case study of a client with depression were analyzed using QUAM. Through this analysis, we found that QUAM permitted a close inspection of the individual in their social context, through an examination of the dialogs that were generated around a range of internal and external I-positions. The main strength of the method was being able to analyze the origins and changes in the relation between internal and external I-positions. The main limitation is in reliably distinguishing I-positions. [ABSTRACT FROM AUTHOR]

The use of systematic client feedback tools are known to enhance outcomes in adults psychotherapy clients, but their effects with children have yet to be adequately tested. Hence, we piloted a cluster randomised controlled trial of the Partners for Change Outcome Management System (PCOMS) with children aged 7–11 years old; comparing play-based counselling with, and without, the use of this tool. Ten UK primary schools were randomly allocated to either the intervention or control condition. Data were available for 38 children in total: 20 girls and 18 boys, of predominantly a white ethnic origin (mean age = 8.5 years). Clinical outcomes were the total difficulties scores on the teacher and parent completed Strengths and Difficulties Questionnaire (SDQ). Fifty percent of the schools left the trial between initial recruitment and end of data collection, but participant dropout was low and recruitment rates were satisfactory. Participants in the PCOMS condition showed significantly greater reductions in parent completed total difficulties than those in the control condition, with small to moderate effect sizes on all outcomes in favour of PCOMS. Overall, our design appeared feasible, but needs to ensure adequate school retention and counsellor adherence. [ABSTRACT FROM AUTHOR]

Abstract Aims The purpose of this study was to test the feasibility of a randomised controlled trial comparing six weeks of humanistic school-based counselling versus waiting list in the reduction of emotional distress in young people, and to obtain initial indications of efficacy. Methods Following a screening procedure, young people (13 - 15 years old) who experienced emotional distress were randomised to either humanistic counselling or waiting list in this multi-site study. Outcomes were assessed using a range of self-report mental health measures, with the emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) acting as the primary outcome indicator. Results Recruitment procedures were successful, with 32 young people consenting to participate in the trial and 27 completing endpoint measures. Trial procedures were acceptable to all involved in the research. No significant differences were found between the counselling and waiting list groups in reductions in levels of emotional symptoms (Hedges' g = 0.03), but clients allocated to counselling showed significantly greater improvement in prosocial behaviour (g = 0.89) with an average effect size (g) across the nine outcome measures of 0.25. Participants with higher levels of depressive symptoms showed significantly greater change. Conclusion This study suggested that a randomised controlled trial of counselling in schools is acceptable and feasible, although initial indications of efficacy are mixed. Trial registration Current Controlled Trials ISRCTN68290510.

Objectives: To determine the demographic profile of clients accessing voluntary and community sector (VCS) counselling services for young people and young adults, and to undertake the first systematic evaluation of outcomes. Design: Naturalistic, non‐experimental study design. Methods: A total of 2,144 clients were recruited from nine services in England. Data on gender, age, ethnicity, number of sessions, problem descriptions, and initial levels of psychological distress were collected from clients. Calculations of reliable and clinically significant change, repeated measures t‐tests, effect size estimates, and moderation analyses were undertaken to determine whether pre–post change, over an average of 5.1 (SD = 5.3) sessions, was significant and which variables predicted outcomes. Levels of service satisfaction were also recorded. Results: The demographic profile of clients accessing VCS services was distinct to those accessing statutory and school‐based counselling services, with a greater representation of females, 'older' clients, and clients from Black and Minority Ethnic (BME) groups. Clients accessing VCS counselling services presented with multiple and complex needs. Statistically significant reductions in psychological distress were observed with effect sizes ranging from.64 to.80. High levels of service satisfaction were expressed by clients. Conclusions: This study establishes that clinical outcomes in the VCS are comparable to those reported in school‐based and statutory mental health services in the United Kingdom. VCS services were perceived as being highly accessible and appear able to reach marginalized groups who may not be accessing other services. Practitioner points: VCS services in the United Kingdom may be more accessible to young people from marginalized groups, such as those from BME backgrounds, compared to statutory and school‐based counselling services.Counselling in VCS services is associated with significant short‐term reductions in psychological distress, at a level comparable with the statutory and educational sectors.Clients accessing counselling in VCS services report relatively high levels of service satisfaction. [ABSTRACT FROM AUTHOR]

The establishment of counselling and psychotherapy as "evidence‐based" interventions is contingent on the effective implementation of randomised controlled trials (RCTs) in real‐world clinical settings. This paper identifies some of the pitfalls that led to the termination of a practical RCT in a community mental health setting. It reflects upon the significance of the lessons learned by drawing on similar challenges that are documented in the wider literature. Issues surrounding staff turnover, counsellor engagement and procedural clarity are discussed, as is the conflict between the time required for research procedures and counsellors' clinical time constraints. In our recommendations, we recognise the decisive role of collaboration and counsellor motivation in research partnerships, and the significance of clinical relevance, communication, training and research co‐production in achieving them. Time commitment is identified as the pivotal challenge in the formation and maintenance of collaborative research, but one that also must be overcome for the advancement of the counselling and psychotherapy field. [ABSTRACT FROM AUTHOR]

Objective: The Relational Depth Frequency Scale (RDFS) was developed to measure the frequency of specific moments of profound contact and engagement in psychotherapy. Method: Following an initial process of item generation and rating, Three-Step Test Interviews were conducted with eight therapists and clients to further refine potential items. Sixteen relational depth items were then taken forward for psychometric assessment in an online sample of 336 therapists and 220 clients, each divided into separate "shortening" and "checking" subsamples. Results: Following psychometric scale shortening involving confirmatory factor analysis (CFA) and Rasch analysis, we formed a six item RDFS that could be used with both therapists and clients. The parameters of the shortened form replicated well in the independent checking subsamples with good internal consistency (Cronbach's α =.85 and.93 in therapist and clients respectively), acceptable fit statistics in CFA and Rasch analysis, and moderate to high levels of convergent validity against the Working Alliance Inventory (Short Form, Revised) and Relational Depth Inventory (RDI-R2). Conclusion: As a brief self-report measure, the RDFS can be used to further assess the relationship between relational depth and therapeutic outcomes. Further research is needed to examine the validity of the RDFS in clinical settings. [ABSTRACT FROM AUTHOR]