Counselling and guided self-help

• there are many different types of counselling but they all share some typical features: therapeutic relationship, emotional support and relapse prevention plan
• therapeutic relationship in counselling - counselling aims to create an open, warm and honest relationship so that the client develops trust with the counsillor. the client should feel safe discussing sensitive matters with the counsellor.
• emotional support in counselling - an aim of counselling is to encourage the client to talk about their emotions. this should have a recovery focused or coping focused goal. the counsellor actively listens without judging, and will not usually tell them what to do. the aim is to help the client find their own solutions. the client-counsillor relationship is unlike any other. the client can talk honestly about deep feelings without fear.
• relapse prevention plan in counselling - a key part is to give the client space to discuss previous relapses and warning signs. the client and counsellor work out a plan for when the client relapses so they get back on a recovery path - e.g. identifying aspects of a lifestyle that contributed to relapse and what changes might help next time.
• Guided self-help is a type of talking therapy based on CBT. the cleint works through materials, learning to use CBT techniques with occasional support from a professional.
• practical steps in guided self-help include materials and guided sessions. the self help materials form a carefully structured programme, in print or online. the materials provide advice on CBT techniques, and include activites for client to apply these techniques. they work through the materials at their own pace.
• guided sessions in self-help - the client is assisted by occasional contact with a professional, and this contact varies considerably. a standard 'session' can be on the phone, texts or emails, or face-to-face session or a group meeting led by trained volunteers. it can last 30 minutes and a programme could be up to 6 sessions, one per week. these sessions usually include: reviewing homework tasks, setting goals, discussing how to apply CBT techniques and setting new homework tasks
• a strength of counselling is that it has practical uses and can be used to help a wide range of clients. as it is so flexible, it can incoporate other treatments such as CBT. it can be conducted with individuals, groups and families. the clients needs are at the centre of counselling and so they are more likely to actively engage with counselling and stick with it.
• a weakness of counselling is that there is lack of evidence to support its effectiveness. the benefit of the relationship between client and counsillor is hard to measure the effectiveness and so the evidence is lacking. therefore there is little evidence of counselling being any better than other interventions in helping clients recover from addiction.
• a strength of guided self help is that there is evidence of effectiveness. one study had researchers randomly place participants in guided self help group or a control group. by the end of an 8 week programme of face to face guided self help, participatns stress levels had reduced significantly. stress in the control group also reduced but not as much. the difference was maintained for 6 months. therefore there is evidence that guided self help can be effective in reducing stress.
• a weakness of guided self help is that not all forms are equally effective or useful. guided self help can be so flexible that it 'blurs the boundaries' with other forms of therapy. for example, one of the studies that used guided self help in face to face sessions closely resembled standard CBT, and so this means that it may be the face to face contact with a therapist that is effective, rather than the materials.