Amanda Williamson Coaching and Counselling Service in Exeter, Devon

I trained in integrative counselling and on our course we were encouraged to form a coherent philosophy of counselling and to choose a framework to gel our work, which as integrative counsellors can involve several differing approaches. We were presented with various humanistic frameworks e.g. Clarkson's 5 Modalities of Relationship, The 7 Level Model (also Clarkson - the framework for our training, along with the BACP Ethical Framework), Heron's 6 Categories of Intervention. I struggled to find something that could adequately hold my practice in a way satisfactory to me and I ended up cobbling together 2 models to form a personalised framework. I opted for Clarkson's 5 Modalities of Relationship and Erskine's 8 Relational Needs. This was the best fit for my personal philosophy which is about meeting the client where they need to be met and working from that base point.

I was profoundly influenced by Mick Cooper and Dave Mearns' work in the book Working at Relational Depth in Counselling and Psychotherapy during my final year of training and very much enjoyed attending a workshop on Relational Depth held by Mick Cooper in Exeter last year. I wrote about that experience here.

The Person-Centred Association South West invited Mick Cooper down to Exeter again this year and l was very excited about attending this workshop; Pluralistic Therapy - Extending Person-Centred Principles to Integrative Practice.

Pluralistic therapy is a philosophy of therapy rather than a technique, a concept that sits better with me as I find adherence to one particular school of thought somewhat reductionist, and I believe that it can get in the way of discovering what each individual actually wants or needs. I think that this is why I preferred working with children with special needs as there was more flexibility to stray away from the curriculum and work with exactly what each child needed to flourish.

Mick did a great job of explaining the principles behind the approach which I guess may be partially because he devised the approach along with John McLeod. He summarised pluralistic therapy thus:



Through extensive research Mick Cooper and John McCleod are shattering the myths that many therapists hold. Apparently, clients generally prefer us to be more challenging than we believe they want us to be. But at the same time, clients find it hard to say what they want because of the power imbalance. As I have said before in this blog, I don't want there to be a power imbalance in my therapeutic relationships but the fact is that power is bestowed on us by some clients who may think that we are expert, or more "sorted" somehow.

Despite all the warring between the differing factions of therapy, what emerges from the research is that:



Clients feel more empowered when there is shared decision making, however, some want to have a say and some don't want to at all. What's important here is that clients differ in their wants and adhering to the dogma of one singular approach is not necessarily in a client's best interest (although it might be!).

Pluralism

The term pluralism derives from a philosophical outlook which was explored in William James' A Pluralistic Universe (1908) and by Isaiah Berlin and is the opposite of the philosophical stance of monism, which holds that there is only one ultimate truth. Pluralism holds the belief that there is no one ultimate truth and that there are multiple right answers to a question. There is an openness to ambiguity and multiple perspectives.

Or as Mick said "Allowing the messiness is a more democratic way of being with another". 

This corresponds very well with my personal philosophical viewpoint and so, as I was hoping, the workshop was proving to be music to my ears.

Another word offered by Mick to explain the approach was dialogic.

Pluralism in therapy

Mick looked at the common arguments in the therapy world, i.e. "relationship versus technique" and 'single orientation versus integrative/eclectic approaches", 'pro/anti-pharmaceuticals" and argued that with pluralistic thinking we don't have to polarise.

Pluralism versus Integrative Approaches

It was clarified that these two definitions come from different traditions. Pluralistic practice is described as "collaborative, integrative practice". Integrative practice does not necessarily involve client collaboration. Pluralism would involve client-focused integration rather than therapist-focused integration.

Metatherapeutic dialogue

This is the word used to describe the talking about the process of counselling itself rather than the issues brought to the room and is central to the pluralistic approach. Is the therapy working well for the client? What is their preferred style of counselling and which techniques/approaches do they feel comfortable with? What do they want to get out of therapy and are they on track?

The importance of this was highlighted. We may miss much of what clients experience or want for various reasons, e.g.:

• a client may want to be seen to be a "good client"
• they may fear that the therapist will retaliate if they question the approach
• a client may view the therapist as "expert"
• the client may feel bad about being seen to criticise the therapist in any way

So the onus is on us as therapists to check out with the client regularly.

Form filling

Role play

Reflection

Therapeutic Orientation Inventory

What about Relational Depth?

Fingers crossed Mick might pop over to Exeter again next year to deliver another thought provoking workshop that therapists can really use to enhance their practice - the whole purpose of Continued Professional Development (no pressure).

[UPDATE 19th August 2014: The issues covered in this post regarding the lack of regulation and the shocking Palace Gate scandal have now been published by The Mail on Sunday as a matter of public interest. Please click here to read more about this important piece with a link to the Mail on Sunday article.] 


I wrote extensively about my stance on regulation around a year ago. I was so fed up of hearing therapists argue the toss about whether it was a good or bad thing.



What about clients? What about the public? What do the people that come and spend time and/or money on our professional services want? Well, I do care deeply about what my clients want so I went out and asked the public and hey presto! Guess what? The majority WANT counsellors and psychotherapists regulated and MOST OF THOSE ASSUMED WE WERE ALREADY REGULATED.

Why is this a problem? Well, like a lot of things that lead to big changes in priority, the real push for me was experiential learning; witnessing serious misconduct in a fellow professional. This was so bad that I resigned from the agency I was working in, that he owns and runs as a private business.

Cutting a long, almost two year horror story short, Palace Gate Counselling Service, the agency I worked at for two years, was taken to two separate complaints hearing by the BACP (British Association for Counselling and Psychotherapy) and each individual complaint warranted removal of the agency's membership. Yes, this agency acted so disgracefully in the eyes of the regulating body that their membership was removed twice.



The BACP are generally quite forgiving and lenient to therapists who have acted in contravention to The Ethical Framework for Good Practice in Counselling and Psychotherapy. Their monthly publication Therapy Today sees a summary of the latest sanctions which usually amount to writing a self-reflective essay and submitting to the BACP, and ramping up supervision. It takes a lot for the BACP to withdraw membership and if the complaint amounts to the therapist's word against the client's then it is my understanding that it is particularly difficult for the BACP to uphold, unless they have a LOT of evidence. 

So the practitioner at the centre of these complaints, who is not and I assume never will be a member of a regulatory organisation, was able to "hide" behind the organisation. 



A blogger who write extensively about the uses and abuses of therapy, and in particular the problem with the lack of regulation is Phil Dore aka Zarathustra. He followed the story after the agency posted a rather bizarre blog regarding the complaints against them. He wrote an interesting piece about the BACP findings here.

Jemima, who writes on Sometimes it's Just a Cigar,  picked up the story here. A commenter on that particular post writes a lot of sense:

"That we have a system where people who are quite possibly vulnerable and traumatised can be ‘treated’ by totally unregulated counsellors is not just wrong it’s dangerous. Every industry needs rigorous, enforceable guidelines and penalties for those who infringe them. There’s nothing to stop me putting a sign up at my door and offering ‘counselling’, just like that awful woman who tried to ‘cure’ someone of their homosexuality. Change is long overdue and any decent therapist or counsellor would welcome it."

What frightens me is that trainee counsellors who work for these organisations are being taught how to practice by owners, directors and supervisors who not only refuse to be held accountable, but have been twice struck off their professional body.

Well for starters, beauty isn't clean shaven armpits and Botox-frozen foreheads, not in my opinion. But you wouldn't think that was the case from all the crap we are bombarded with in magazines/on the internet/billboards.

I am supposed to be writing my accreditation essays this morning. Yesterday, when I was in full flow on the longest of the four pieces required, my butterfingers ended up flinging the last dregs of tea onto my keyboard. It broke. I couldn't fix it and am now behind where I wanted to be, essay-wise. So here I am with a new keyboard, with a free few hours, and ready to go. Except I need to get something off my chest, and it's been a long time coming.

Madonna's Armpit Selfie

The first contributing factor (besides growing up and spending years of being being faced with cultural expectations of "beauty") was Madonna's so-called Armpit Selfie that she shared on Instagram. I have only seen a fraction of the onslaught of comments and whilst I'm not surprised it has caused an outcry (I mean, what a slut, deliberately flaunting it) I continue to be disturbed by comments such as "It's as bad as not washing" to "I just vomited".

I also saw an article from The Independent tweeted which is in some respects very silly (Beyoncé really isn't that inspirational) but also makes some important points about natural hair.

My Armpit Selfie

In the heady days of MySpace being The Social Network to be using and cruising, I changed my profile picture to one of a woman's arm and torso, showing one hairy armpit. It wasn't mine, but wow did I get some vehement responses from a LOT of people. Some blokes I didn't even know telling me how disgusting I was. Wow.

What are we doing to our kids?

Having three children of late primary and high school age, the topic did come up fairly recently. I asked them what they thought about women having hairy legs or armpits. Two were ambivalent. One (male) said that it seemed stupid and pointless to remove it. I inwardly glowed. These are the kids that do not like clothes because they are fashionable, they like clothes in colours and fabrics that please their individual tastes. My daughter cannot understand the obsession with people trying to look younger - "What's wrong with looking your age? What's wrong with wrinkles?". Good questions. Which leads onto the next piece of crap I saw this morning, via the internet: "Celebrities who are Aging Horribly".

*sigh* I am actually getting really fed up of seeing actors Botoxed and Filled up to their eyeballs. Where are their natural expressions? It looks fake and weird and spooky to me. How is that beauty? I first noticed it in The Golden Compass where the then 39 years old Nicole Kidman's forehead was smoother than her 11yr old co-star Dakota Blue Richards (as well as totally frozen). Weird.

and also…"30 Fairly Shocking Pictures of Celebrities Without Make-up".

I suppose we did have the recent phenomenon of the no-make-up selfie where hundreds of thousands of women bravely dared to go bare-faced (a few of those with a hint of Instagram photo make-over).

I am disappointed in this aspect of society because I want people to love me and love my children and love the people I love, because of who they are. Because of their uniqueness and quirks and flaws. Is love insisting that your girlfriend shaves down below? I'm not blaming men here, we're all at it, we're all responsible for this, and things are getting worse for men too as more and more men seek cosmetic surgery.

Junk food for the Ego

Seeing evidence of celebs' cellulite and plastic surgery makes me feel fleetingly better about myself, but feeding the ego such a rubbish diet leaves a post-crap-consumption crash.

I gave up reading fashion magazines years ago. But now I have this garbage injected into my psyche by simply using Yahoo email and having a Facebook.

I saw this amazing slam poetry video a few years ago and it stays with me. The message haunts me, because she's right and she eloquently, and bluntly at times, highlights what is so wrong with our cultural ideals of beauty and why we are missing out on what's really important:

(if you can't see the video on your device click here:)

Here is a list of the books that influenced me, that helped me grow as a person, at various stages of my life, pre and post counsellor training.