Making Sense of Counselling and Its Outcomes: Client and Counsellor Perspectives.

The starting point for this study was a series of critiques of counselling which seemed to be based on an essential misunderstanding of the activity. Firmly located in a medical model, counselling was portrayed as an ineffectual response to the hypochondriacal whims of a self-absorbed populace, in an attempt to ape the legitimate endeavours of psychiatry, psychoanalysis and psychotherapy in curing ‘real’ mental illness. Building on the work of authors who have sought client and counsellor views in a qualitative way, the study set out to challenge the fundamental misconception at the heart of these critiques. Based on case studies of nine client counsellor pairs and an additional five therapists, the findings showed that the correction, cure and growth models of counselling and psychotherapy theory, although not irrelevant in practice, were just a tiny part of what people sought and gained from counselling. Comparing these findings with outcome research and other literature describing different ways of thinking about counselling, two new models are proposed. One suggests an inclusive framework for understanding counselling in theory and practice. The other sets out an alternative way of thinking about outcome. Unlike traditional models this latter allows for a variety of process (doing) and social (relationship change) outcomes as well as a range of personal changes within and beyond the counselling experience. The study concludes by highlighting some implications of adopting the models for counselling theory, practice and research