Paul Nicholson

Opinion piece commenting on NHS research into childhood mental health issues.

The Growing Rooms counselling project at St George’s Crypt is embedded within a wider alcohol and drug rehabilitation service for homeless and vulnerable adults in Leeds, West Yorkshire. The evaluation of the project examined clients’ experiences of engaging with the counselling service provided in order to understand the development of the therapeutic relationship and the impact of counselling on clients. The findings drawing from the voices of the participants highlighted the following: • Voices from those accessing the service on the impact of counselling. • Further insight and understanding of benefit of counselling in helping individuals presenting with complex, multi-layered challenges. • Recognition of the time needed to engage and complete process. • Importance and appreciation of interventions offered to this service user group. • Results and evidence base, as identified by Clinical outcomes in Routine Evaluation CORE-18, demonstrate reliable and positive change in the participants’ wellbeing. • Strong appreciation of help offered by counselling and The Growing Rooms at St. George’s Crypt. Given the limited number of therapists and services working in this specialist area, published results from this study will raise awareness of this line of work and encourage more therapists to work within it. Results from the research conducted and the contextualization, which took place within the evaluation of this project, will provide practitioners and policymakers with important information that can help inform commissioning decisions and service provision for individuals presenting with homelessness, substance misuse and social isolation.

Abstract

This article explores the prospect of delivering counselling to people affected by dementia from the perspective of persons responsible for delivering an integrated dementia support service, emphasising an underpinning relational approach. Findings originate from interviews with an experienced counsellor, the counselling service co‐ordinator and people affected by dementia. Framework analysis was adopted to generate themes related to the study aims. Effective counselling delivery is reliant on the counsellor’s practice philosophy and appreciation of the lived experience of dementia from a person‐centred understanding. Participants discussed the benefits to offering a holistically understanding service, supportive of the needs of people affected by dementia, and how this can affect access or uptake of counselling. Findings demonstrated that counselling is a worthwhile and effective intervention to offer to people living with dementia and family caregivers. A number of recommendations for adjusting the scope of relationship‐based counselling to promote effective delivery have been made.

Counselling and other psychotherapeutic interventions can be offered to people with dementia and their caregivers, to treat specific conditions or symptoms (e.g. affective disorders such as depression). Psychotherapeutic interventions also offer the opportunity for individuals with dementia and their families/caregivers to engage in psychological support for a wide range of presentations. However, little is known about how those within this demographic who receive these interventions perceive the experience. This study aimed to understand the experiences of individuals with dementia or caring for someone with dementia, before and after a 12-week relational counselling intervention delivered through a third sector organisation within England. Semi-structured interviews were completed with participants (29 pre-intervention and 25 post-intervention). Framework analysis was conducted, with four main themes identified; expectations and outcomes of counselling, emotional impact of life with dementia, appraisals of identity, and importance of therapeutic relationship. Participants reported that counselling interventions addressed a range of needs and concerns that they had, enabling them to reassess and reconsider these. Specific training is needed before therapists deliver therapeutic interventions with people with dementia, to ensure that appropriate support is provided for those with more severe cognitive impairment or who may have fluctuating capacity. Future research should explore the experiences of people with dementia and their caregivers, across different counselling modalities, to establish the appropriateness and effectiveness of relational counselling.