13 Chapters
Medium 9781855757516

CHAPTER SIX: The primary care counsellor’s support systems

Garrett, Valerie Karnac Books ePub

Your effectiveness as a counsellor in any setting can depend considerably upon how well you feel supported. I divide this section into two: external support and internal support. External support is just as it says, relationships, structures, and systems which are in place for the counsellor, with the internal support being the counsellor’s inner world and its projections. I cannot stress strongly enough the counsellor’s need of personal support systems. The counsellor is a human being, and, as such, is prey to becoming emotionally vulnerable at any time.

External support

Professional support comprises collegial and peer relationships, CPD (continuing professional development), and membership of accrediting and professional bodies. In the primary care setting, staff alliances and knowledge of the unique culture of the medical organizational setting are very important. Last, but not least, your accrued body of knowledge and experience in your subject will support you.

Never forget that when working in primary care, you are subject to the same group pressures as everyone else working in that setting. You may become just as competitive, resistant, and reluctant to expose your failures, weakness, incompetence, and insecurity as the other members of staff, but you are likely to be more self-aware and have understanding of the unconscious processes at work. This self-awareness and understanding is part of your support system.

See All Chapters
Medium 9781855757516

CHAPTER SEVEN: Whose needs are being met?

Garrett, Valerie Karnac Books ePub

This chapter is about recognizing whose needs are being met by a referral to counselling. This assessment of need may begin before the clinical assessment of the patient.

The GP’s needs

As I have mentioned earlier, a patient’s symptoms, emotions, or behaviour can arouse distress and/or unease in a GP, other referring member of staff, or a patient’s family members. Sometimes, it is difficult to divine whose distress is actually being displayed. By this, I do not mean that the patient is not distressed, but he/she may be containing and/or acting out a family or marital problem; in other words, they become the person identified as the patient. Sometimes, this is obvious to the GP treating the patient, and some useful work can be done, in consultation with the counsellor, to try to identify the best course of action and/or therapy for the whole family or couple, in addition to helping the “identified patient”. The identified patient may be unconsciously containing and displaying strong emotions and conflicts for other members of his/her family. I use the word “contain” here referring to the term and meaning contributed by Bion (1962a,b, 1970), that of “container– contained”. I elaborate on this concept later in the text.

See All Chapters
Medium 9781855757516

CHAPTER TEN: Use of psychotropic drugs, their probable impact upon counselling, and their side effects

Garrett, Valerie Karnac Books ePub

This chapter is taken from the BACP information sheet P8, 2005, written by Rachel Freeth, which she produced to provide an introduction to psychopharmacology for counsellors, psychotherapists, supervisors, and trainers (Freeth, 2005). I have included additional information supplied by the Depression Alliance.

Drugs are often prescribed with the same broad aim as counselling and psychotherapy, that is, to improve psychological functioning. The primary care counsellor will come across patients who are taking drugs, and this may be a concern to counsellors who are new to working in a healthcare context. It is useful, therefore, to have some knowledge about psychotropic drugs, including why they might be prescribed and their potential benefits and harm, and possible side effects that may affect the emotions or normal everyday functioning.

What is psychopharmacology?

This is the name given to the scientific study of the chemical receptors to which psychoactive substances bind, of the levels of these substances that are achieved in the brain, and of their effect on psychological functioning.

See All Chapters
Medium 9781855757516

CHAPTER ONE: Setting the scene of primary care counselling against the backdrop of a rapidly-evolving NHS service

Garrett, Valerie Karnac Books ePub

This chapter tracks the progress of counselling provision in primary care against the backdrop of the history of the NHS and the rapid changes which have occurred over the last two decades.

We will begin by looking at how changes in the NHS over the past twenty years have affected and continue to have an impact upon the service as we see it today.

Stability and change in the NHS from the late 1940s

Probably most people would agree that the inception of the NHS in the late 1940s was “the best thing since sliced bread”, especially in the aftermath of the Second World War, a time when the public purse really was tight. We must never forget those years before the NHS, when even basic healthcare was only for those who could afford it.

What has changed? If the reader is over sixty years of age he/she may remember just how it was and recognize that things have changed out of all recognition. The period from the late 1940s until the late 1980s was a time of relative stability in the NHS, and one could argue that, in that time, it was an improving service. That time of stability can now be seen in stark contrast to the rapid changes that have occurred in the past twenty years.

See All Chapters
Medium 9781855757516

CHAPTER EIGHT: Time and how we use it: assessing what is appropriate for the patient

Garrett, Valerie Karnac Books ePub

By whichever model of counselling the reader is guided, this seems a good place to talk about the importance of time. Most counsellors agree that the concept of time is important and that we, as humans, are not just as we seem in the moment, but that our lives are influenced by our past experiences as well as our ideas about our present and future. Whatever we wish to call this phenomenon, our behaviours are not only ruled by our conscious thoughts and feelings. We, as therapists, have a duty of care to embrace this concept fully for our patients. As Mann says, “One way of understanding the failure to give time central significance in short forms of psychotherapy lies in the will to deny the horror of time by the therapists themselves” (Mann, 1973, p. 10).

Mann believes that any time-limited therapy must recognize that child time and adult time are in the counselling arena, that is, children experience time differently from adults. This fact can give rise to powerful conflicting reactions, responses, and expectations, as the inner child of the person wants and expects as much time as he/she needs, whereas time in the adult world is often rationed and limited. For example, if we are making a meal that requires several ingredients and we discover that one crucial ingredient is nowhere to be found, we may swear or kick the cat. Most people would agree that this behaviour falls within the bounds of normal. But, for some people in certain situations, their reactions may be excessive and harmful either to themselves or someone else.

See All Chapters

See All Chapters