Despite the sensitive nature of their work, there are virtually no regulations for counsellors in this country, writes Paul Cullen
Why is counselling in the news?
Last weekend, The Irish Times revealed that clients of one Dublin counselling centre were asked for large sums of money upfront for counselling and life mentoring. Throughout the week, more people emerged who said they had paid large sums of money to the centre; one said he had to sell his home and was "practically bankrupt" after paying over €235,000, which has since been refunded. The issue has prompted an investigation into the allegations as well as throwing the spotlight on one of the fastest growing yet least regulated sectors of society.
What is counselling anyway?
Counselling is a process that enables a person to sort out issues and reach decisions affecting their life, according to a typical definition. It's usually resorted to at times of change or crisis in a person's life, but not always so. It generally involves talking with a person - the counsellor - in a way that will help solve a problem or change unwanted behaviour.
That's the easy bit. There are, however, as many types of counselling as there are counsellors; one researcher estimated that there were more than 400 types of counselling, many of them very different in their origins and approach. These variations are reflected in the different names used for the professionals who provide counselling.
The spectrum includes counsellors, psychotherapists and behavioural therapists, but doctors, psychologists and psychiatrists, of course, also provide advice, and some have specific qualifications in counselling. More recently, there has been a boom in the linked disciplines of life coaching and mentoring.
Many counsellors follow a person-centred approach which stresses listening to the client, while others who ascribe to cognitive behavioural theories take a more interventionist approach which involves changing patterns of thinking and acting. Approaches can vary according to circumstances; a person recently bereaved might need a sympathetic ear, but someone who still has problems a few years after a death in the family might benefit from more active intervention.
According to counsellor and journalist Padraig O'Morain, what really matters is not the theory but the relationship between counsellor and client. "If that's good, the client will make progress." Many counsellors have specialised areas; addiction counsellors, for example, deal with people suffering from alcohol, drugs, gambling or other addictions.
Is counselling the same as psychoanalysis and psychotherapy?
Methods of psychoanalysis based on the teachings of Freud, Jung and others were slow to catch on in Ireland and have probably passed their high water mark internationally. Just like the Woody Allen films of the 1980s in which therapy played such a central role, they never got beyond a niche audience here.
Both techniques tend to be more indepth than counselling and place greater emphasis on examining the subconscious mind. Proper training in techniques of psychoanalysis takes years to acquire whereas counselling courses tend to be shorter. Equally, though, treatment by analysis can go on for years, and is therefore more expensive and unsuited to clients seeking quicker outcomes.
You mentioned life coaching. What is that?
The Life and Business Coaching Association of Ireland defines its discipline as "the art of facilitating another person's performance, learning and development. It is the process of inspiring an individual or team to produce a desired result through personalised teaching, expanding awareness and designing environments." The association says a good coach provides direction and concentration for clients' energies, helping channel all their efforts towards "that single desired outcome".
Clear?
No, well I don't understand it either. However, it can be said that, while counselling will inevitably examine a person's past, life coaching tends to look to the future and is more goal-oriented. Mentoring is similar, and involves a person with greater experience guiding someone with less experience.
Why are people going for counselling?
People have always had problems, naturally, but the way they deal with them has changed. "Once we turned to the Church for advice, but that has declined, and we have less time for friends and family," says O'Morain. "We spend more time on our own and there is less of a stigma attached to talking to a counsellor."
James Reilly, a GP who was elected to the Dáil this year and is now Fine Gael's health spokesman, says there is a huge need for counselling services. "It's a grossly under-resourced and under-exploited area. Many problems that people bring to GPs could be handled by an affordable counsellor." So, instead of a doctor prescribing anti-depressants for a patient over long periods of time, the right kind of counselling could wean the person off the need for this support.
So it's good to talk, but are there many counsellors out there?
The Irish Association for Counselling and Psychotherapy (IACP) claims about 2,500 members and there are probably as many counsellors again who are in other bodies or unaffiliated. That seems like a lot but by all accounts there is plenty of work for them. A typical charge would be about €55 for a session, and treatment might involve four to 10 sessions. A good counsellor will direct a client with persisting problems to more specialised help.
What kind of regulations are in force?
None, or at least nothing official and legally binding. As even those in the business will acknowledge, the term "counsellor" embraces huge variations in ability and levels of training. Like estate agents, counsellors are unregulated and anyone can set himself up as one. Reilly remarks: "My problem as a GP referring patients is that half the time I can't be sure of the competence of counsellors. You have people doing six-week courses and saying 'Hey presto! I'm a counsellor.' I've certainly come across people whose qualifications are not what they ought to be."
As long ago as 1999, Reilly and other members of the health board were calling for a national register of counsellors to be set up. "I am concerned that there are many calling themselves counsellors who may have done nothing more than a weekend correspondence course," the vice-chair of the board was quoted as saying. Eight years on, not much has happened. A working group was set up to plan for statutory registration but this has yet to be introduced. Last year, after controversy over an agency providing counselling services to pregnant women, the Crisis Pregnancy Agency called for the setting up of a regulatory body.
There has been some self-regulation. Members of the IACP have to have completed a two-year diploma course and have carried out 450 hours of counselling under supervision. This organisation and others operate codes of ethics, but the extent to which compliance is monitored is not clear. Confidentiality is a core principle of such codes, understandably, given that counsellors are often privy to private and potentially embarrassing details of their clients' lives.
I think I need help. Who should I turn to?
Many people access counselling through their GP; word of mouth is also powerful. Decide which branch of counselling best fits your needs and choose accordingly. Make sure the counsellor is a member of a reputable professional body. Don't expect results too quickly and move on if you're unhappy.