1.1 What Are Counselling and Psychotherapy? COLIN FELTHAM DEFINITIONS AND AIMS A brief, tentative definition of this kind offers some parameters but omits mention of the many, ever- expanding, often competing, schools of therapy, No single, consensually agreed definition of either and the arenas and the several professions (some- counselling or psychotherapy exists in spite of many times in conflict) in which they are practised. attempts across the decades in Britain, North America Discussions of all such conflicting claims can be and elsewhere to arrive at one. The question of pin- found in Feltham (1995) and James and Palmer ning down crucial distinctions arose in concrete (1996). The contention advanced by this book’s edi- terms in the UK in the first decade of the twenty-first tors is that counselling and psychotherapy, in spite century when the Health Professions Council (HPC) of partly different historical roots and affiliations, initiated preliminary steps towards legal protection have much more in common than they have serious of the titles ‘counsellor’ and ‘psychotherapist’. and demonstrable differences and that practitioners Attempts to load the former with wellbeing-associated and the public stand to gain much more from the tasks and the latter with competencies in addressing assumption of commonality than from spurious or more severe psychological problems soon broke infinitesimal distinctions. It is often acknowledged down. For the purposes of this book, the following that ‘British counselling’ much more closely resem- provisional working definition is offered: bles psychotherapy as practised in the USA and Counselling and psychotherapy are mainly, though not parts of Europe than it does the various kinds of exclusively, listening-and-talking-based methods of guidance and mentoring that it is often confused addressing psychological and psychosomatic prob- with. Certainly practitioners in this field work with lems and change, including deep and prolonged many different types of goal and expectation, human suffering, situational dilemmas, crises and implicit and explicit, each of which may call for the developmental needs, and aspirations towards the use of somewhat different skills, but arguably little realization of human potential. In contrast to biomedi- is to be gained practically from further controversy cal approaches, the psychological therapies operate about professional titles and distinctions. largely without medication or other physical interven- tions and may be concerned not only with mental health but with spiritual, philosophical, social and DEVELOPMENT OF PSYCHOTHERAPY AND other aspects of living. Professional forms of counsel- COUNSELLING IN THE UK ling and psychotherapy are based on formal training which encompasses attention to pertinent theory, clinical and/or micro-skills development, the personal Sigmund Freud was developing psychoanalysis – development/therapy of the trainee, and supervised often considered the grandparent of most of the practice. diverse schools in existence today – in Austria in 01-Feltham & Hortaon-4308-Part-1.indd 3 13/09/2011 7:09:20 PM 4 PART I COUNSELLING AND PSYCHOTHERAPY IN CONTEXT the late nineteenth and early twentieth centuries. information is available in Aldridge (2011). It is Before Freud there were certainly many kinds of usually agreed that early American vocational guid- psychologically oriented therapies and many had ance projects and associations (for example Frank already used the concept of an unconscious. Parsons’s Vocation Bureau in Boston in 1908) laid However, Freud has come to mark the historical the foundations of counselling, and guidance for the pivot when previous centuries of religious, philo- young generally was a strong element. This cer- sophical and pseudo-scientific theories and meth- tainly features in the early career of Carl Rogers, ods (from religious propitiation to shamanism, who is probably the closest to being the ‘founder’ of sleeping cures, magnetism, hypnotism, etc.) were (non-directive) counselling in the 1940s. Another challenged by serious aspirations to establish psy- player is perhaps Rollo May, who, influenced by chotherapy as a scientific discipline. Psychoanalysis Alfred Adler, wrote what many consider to be the is perched curiously between being perceived as a first counselling text in the 1920s (May, 1992). In challenge to previous faith in reason (the the USA counselling was also originally closely Enlightenment) and as itself, the new grand narra- linked with personnel management and the work- tive capable of rationally explaining all the psycho- place. In general it is true to say that counselling has logical ills of humanity. Freud is often (although not historical roots in practical guidance and problem- by all) ranked with Darwin and Marx as one of the solving issues, and was often agency based rather most significant scientific thinkers at the dawn of than associated with private practice. However, it is the twentieth century. now mainly characterized as distinctly other than Psychoanalysis moved through Europe and advice giving and as having a primarily facilitative North America in the first few decades of the twen- function. tieth century, the International Psychoanalytical Seminal events in the UK included the establish- Association being established in 1910 and the ment of the National Marriage Guidance Council in British Psychoanalytic Society in 1924. The British 1938, the importation of counselling training meth- Association of Psychotherapists (originally the ods from the USA to the Universities of Reading Association of Psychotherapists) was founded in and Keele in 1966 (to serve the pastoral needs of 1951. In spite of much public and medical resist- students), and the establishment of the Westminster ance to psychoanalysis (which was originally radi- Pastoral Foundation in 1969. The Standing cally counter-cultural), interest and support grew, Conference for the Advancement of Counselling in partly in connection with the two world wars and 1970 led to the formation of the British Association the search for remedies for ‘shell shock’ (the pred- for Counselling in 1977, renamed the British ecessor of post-traumatic stress disorder, PTSD) Association for Counselling and Psychotherapy and other problems experienced by military person- (BACP) in 2000. It should be said that a great deal nel. Concern about scientology led in 1971 to the of cross-fertilization between these developments Foster Report [C1.1Q1] which had implications for and others in psychotherapy was taking place and psychotherapy, and in 1978 to the publication of the the emergence of psychodynamic counselling, for Sieghart Report [C1.1Q1] on the statutory regula- example, demonstrates these close links. tion of psychotherapists. During the 1980s confer- Alongside these developments we should also ences regularly held at Rugby (organized by the note pertinent developments elsewhere. Originally British Association for Counselling (BAC)) led the Association of Medical Officers of Asylums and eventually, in 1993, to the now United Kingdom Hospitals for the Insane (AMOAHI, founded 1841), Council for Psychotherapy (UKCP). The British the Royal College of Psychiatrists was so named in Psychoanalytic Council (BPC), representing train- 1971. The British Psychological Society was estab- ing institutions with a strictly psychoanalytic affili- lished in 1901. Significant mutual aid and volun- ation. The UKCP, containing member organizations tary organizations such as Alcoholics Anonymous from humanistic, cognitive-behavioural and other (1935), the Samaritans (1953) and Cruse (1959) traditions, was established in 1991. In recent years should also be included in this brief portrait, as it has extended its membership categories to include should the parallel existence of the personal ‘psychotherapeutic counsellor’ and more flexible social services and its casework tradition which routes to membership. closely mirrored developments in counselling and The development of counselling is harder to psychotherapy. trace, there being no single dominant figure like Theoretically, psychotherapy and counselling Freud, or monolithic theory like psychoanalysis. develop continuously, some might say all too pro- Hans Hoxter may, however, be credited as one out- lifically, with significant departures from psycho- standing individual for his part in creating the coun- analytic theory and practice observable from its selling movement, including bringing American earliest days. Jung and Adler were among the earli- training ideas to Britain. Further relevant historical est to break away from Freud, and similar schisms, 01-Feltham & Hortaon-4308-Part-1.indd 4 13/09/2011 7:09:20 PM 1.1 WHAT ARE COUNSELLING AND PSYCHOTHERAPY? 5 factions and developments are in evidence throughout Each has designated tasks that obviously differ psychotherapeutic history. Hence resulted the from those of others, depending on context and cli- growth of what is still thought to be the more than ent group. Counselling and psychotherapeutic skills 400 schools (also known as theoretical orientations, are used to degrees in all these professions and, approaches, brand names) of therapy we have where individual workers possess dual or multiple today. The question of whether such proliferation is qualifications (for example a social worker may be desirable and in clients’ interests, or not, must be trained in family therapy), they may formally pro- faced by thoughtful practitioners, and indeed