Therapy Today October 2014
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| So are institutions letting down students in their drive to recruit large numbers? Sir Bob Burgess, Vice Chancellor of the University of Leicester, acknowledges the financial pressure across the sector. ‘I think this year has been the most challenging I can remember,’ he says. ‘And it’s inevitable that, when the Government announces cuts, that’s going to trickle down to staff and to students.’ He accepts that, for some students, the pressures of the new fee structure will contribute to their difficulties but argues that, as greater numbers – some 50 per cent – of young people now enter HE, it’s natural that the level of demand for support will increase. He believes there is a need for more personal tutors offering pastoral care, more funding for counselling and for staff training in mental health.
‘It would be good if we could increase funds for these forms of support,’ he says, ‘but in the current climate that is challenging to deliver.’ Another useful support for students who are assessed as having a mental health problem has been the Disabled Student Allowance (DSA), although this is currently ‘under review’ by the Government. This allowance enables students who are assessed as eligible to have a mentor to help them with a range of supports, including stress management and confidence building. Outsourcing threat Meanwhile the pressure on counselling services, usually working to frozen budgets, continues to build. In terms of practice, Ruth Caleb says this means that, in many cases, counsellors are often unable to see a student for as long as they might need. Time is taken up by the sheer numbers of requests, including supporting those whose complex needs may require regular check-ins for the whole of their course. Waiting lists are long – both in university counselling services and in the NHS. In many services, she says, particularly those with lone counsellors for whom there is little or no extra cover at busy periods, practitioners become overwhelmed and burned out. They have little time for CPD or peer support or time to plan the crucial input they can offer an institution to academic practice and student wellbeing: ‘The more pressure we are under from the people coming to see us, the less we are able to do preventative work – staff training, student groups and other strategic activities. Counselling services tend to be the boats in the water with the fishing nets fishing people out. We need to see why they are jumping in.’ In such a climate, the spectre of outsourcing university counselling lurks in the shadows. It’s already happened in Northern Ireland where all HE and further education (FE) counselling is now contracted out. Patti Wallace argues that outsourcing is not the answer in an age of growing psychological demand, as properly funded, embedded counsellors can offer much more. Located within the educational environment and with relationships across departments, staff counsellors not only see students one-to-one but can run groups and workshops, support and train staff and input to management in a crisis. Nowadays, she says, the remit of on-site counsellors has widened so much that BACP is currently developing a new competency framework for the kinds of skills required to work in both FE and HE: ‘Today we look for people who have knowledge across mental health issues; experienced people who have worked in a range of settings, who are good at assessing and deciding what’s going to be the most useful intervention for this client in this context; people who are able to see someone bringing three or four different issues and work out how they can help them get to the point where they can function again adequately within this context rather than trying to help them resolve every issue in their lives.’ Creating dependency? For Alan Percy, Head of Counselling at the University of Oxford, this new era challenges HE counsellors to reflect on what we do and why. ‘The key thing for all counselling services is not to be pulled away from the key performance indicators,’ he says. ‘The measure of the effectiveness of the service is the effectiveness of the clinical interventions. It is important to evidence the real changes – in terms of feeling, symptoms and functioning – the service has made to the students who use it.’ He agrees with Patti Wallace that speed of access to counselling is very important, but argues that the perceived need for an immediate response – by the student seeking help and perhaps by the institution – must be tempered by this understanding about effectiveness. Our priority, he says, is to select the most appropriate intervention for each student from a repertoire of self-help, groups, workshops and one-to-one counselling. As for how many sessions are offered, he argues it’s better to give most people one or two and protect the possibility of a limited amount of medium and long-term work for some than to make a more average offering to all. ‘I think that puts a lot of emphasis and responsibility onto the individual doing the assessment,’ he says. ‘But if you’ve got highly skilled qualified counsellors, that’s where they should be deploying their skills.’ The key, he argues, is to resist the pull to offer one-to-one work: to balance demand and expectation against the reality of what a service is able to do. In his service, much of the longer-term work is done by (trainee) associate counsellors, who may need long-term experience as part of their course learning; higher risk work is managed by core counsellors linked into other support services. Like Charlotte Halvorsen, Ruth Caleb and Patti Wallace, Alan Percy believes a staff counselling service can be a proactive holistic force within an institution, contributing widely to student wellbeing and increased understanding among staff about mental health and the difference they can make to this. However, he argues that greater general understanding about mental health also has a downside. For him it’s one of the drivers for the rising demand for counselling that, in his view, are independent of the new financial realities of higher education. They include an over-medicalisation of student distress: ‘If every difficulty or upset is symptomised as a mental health illness,’ he says, ‘it makes it a lot harder to deal with both for the student and for those trying to help, rather than understanding it as a difficulty which is very distressing but is a normal consequence of the person’s developmental process. If that is seen as an illness, it becomes a way of objectifying the person, making them feel passive, undermining their self agency and expecting someone – a doctor or a counsellor – to sort it all out.’ ‘Consumerised’ climate Instead of creating a new form of dependency, Alan Percy argues, counselling is more helpful if it allows a young person to individuate, so developing their own internal resilience. He theorises that a general societal shift to more ‘child-centred parenting’ has been partly responsible for raising some young people who, while apparently more mature and confident, are in fact more emotionally dependent on their parents and come to university with a greater expectation of being looked after. ‘The risk is that institutions parallel over-protective parenting by trying to satisfy impossible demands and expectations,’ he says. Setting this alongside a point made by many academics that the new fee structure has spawned a climate of ‘consumerisation’, that increasing numbers of complaints are made by today’s HE students who see their £9,000 a year ‘buying’ them the right to a whole range of services, including counselling, the potential dangers become evident. Our responsibility as HE clinicians, argues Alan Percy, is to be clear in the face of others’ expectations and to spell it out that change involves hard work and engagement on the part of the person seeking help: ‘If you’re not honest right at the beginning, giving a coherent message about what you can and can’t do, you are inevitably going to be setting up disappointment and dissatisfaction,’ he says. So have our students – and sometimes as importantly their parents – morphed from clients to customers since I started my work in HE? To some extent I would say yes. Then how does that play out in the power dynamic of the therapeutic relationship? I believe, with Alan Percy, that it is crucial for us to be assertive about what we can and can’t offer. For, unlike those in most other university departments, our job may not always be to offer the customer what s/he wants. At the same time I am probably – consciously and unconsciously – more aware of potential comeback when I make a clinical decision not to take someone on for counselling. I certainly make sure my reasons are logged in my client notes. Knowing the importance of standing my ground – with students and with managers – is crucial. But in a climate of high institutional anxiety and uncertain job security, the challenge as in-house student counsellors is sometimes to be brave enough to do it. Clare Pointon is a psychotherapist, writer and former BBC journalist who has worked as a university counsellor for the past eight years. She runs psychological training courses for staff and students, as well as relaxation classes. Reference
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Student–tutor conflict in counsellor training As counselling tutors/trainers embark on a new academic year, Jayne Godward reports on her research into experiences of managing student–tutor conflict Training people to become counsellors is rather like trekking through a jungle. It is extremely interesting and, at times, exciting; you encounter so much that is new and unexpected and there is so much to see, hear and experience. But it is also personally challenging, and you need to be prepared for and alert to the potential hazards. Difficult relational dynamics and conflicts will arise between tutors and students and these can easily lead to you ending up in the swamp, being bogged down and under attack. Conflict is a common occurrence in groups1 and perhaps inevitable on counselling training courses as students become aware of themselves and their own needs. This can be a particularly vulnerable period as they develop personally, attend therapy and work closely in groups with peers and tutors. The key factors leading to conflict identified by Connor2 and Nelson and Barnes3 are the personal issues and vulnerability of both the student and the trainer, the need for trust and safety in trainees, interpersonal dynamics, power relationships, role conflict and ambiguity. Other causes of conflict not to be ignored are transferences, countertransferences and projections on both sides.2 Having waded through this jungle swamp with my colleagues on several occasions, I decided to carry out a qualitative research study to look at the methods experienced counselling tutors use for dealing with conflict between themselves and their students. Nine humanistic tutors with eight to 20 years of counsellor training experience took part in the study. Six were working in colleges and three in universities. They wrote at length about their experiences and ways of managing conflict, and gave specific examples. Four of the tutors also took part in a focus group. My analysis of their responses highlighted two factors in particular that could hinder conflict resolution: the role conflict experienced by tutors between their roles as therapist and tutor, and the organisational context in which they worked. I will look at these factors first before moving on to discuss the strategies that were suggested for dealing with the actual conflict. Role conflict of the counsellor trainer It became apparent during the study that these counselling trainers often experienced a tension between their roles of therapist and tutor. There was a tendency to want to act in a therapeutic and supportive way towards students, whereas being a tutor necessitates carrying out assessments and making judgments about a student’s work and progress and ultimately deciding on their fitness to practise. These dimensions of the professional self could be complementary at times, and counselling skills could be useful in conflict situations; however sometimes the tutor dimension had to have priority, as this was the main aspect of the trainer’s job and the students were not on the course to receive therapy from their tutors. Trainers, particularly those from a person-centred background, talked of using their counselling skills when dealing with conflict (the therapist dimension of the role). One tutor described a difficulty he and a co-tutor had with a student who was questioning the way the personal development group was being run and wanted the tutors to disclose and be more involved. The student felt that he was being observed, assessed and judged in the group but, instead of meeting the tutors to discuss what was going on, he attacked them in the next personal development group meeting. The tutor wrote: ‘What we hoped he witnessed was our ability to stay grounded in the person-centred approach. In doing so we allowed him to share his experience with his peers, without judgment.’ To an extent modelling your counselling approach and getting alongside a student could be helpful and could resolve a conflict situation. However difficulties arose when students were unable to reflect on their part in the conflict or were lacking in self-awareness. The question discussed by tutors in this study was how far do you continue to work in a therapeutic way with students and when does it become unhelpful to the student’s development? One tutor described how she switched to the ‘tutor dimension’ of her role: ‘So in a conflict, when I’ve done what I can to reach out to that student to see what it is, to understand, to get support for them, then the thing I’m wanting to do with that student is to say, “And now I’d like you to reflect on your part in this and I’d also like you to think about how that might be enacted possibly with your clients or with other people out there.”’ Some tutors argued that the key aspect of their role was to keep focused on the training so that students could succeed on the course; others recognised that it might not always be possible: ‘It’s become impossible for them to look at their part in it and then, in terms of training and where we want them, where I want them to be at the end of the course, they’re not going to get there anyway because they can’t look at themselves.’ This would be an example of a situation where, no matter how much empathy and support the tutor gives the student, they still might not be ready to become counsellors at this point and to pass the course. In terms of students’ expectations of their tutors, sometimes they were seen first and foremost as therapists and second as tutors. Focus group members spoke of how students could react if tutors did not live up to their expectations of what a therapist should be like. ‘They have us on this pedestal and see us in a certain way and when we don’t act in that way they can take it quite personally and be hurt and angry,’ one participant said. Another said simply: ‘I can’t always be the therapist they might want me to be.’ Trainers also discussed the responsibility that goes with their role, including the assessment aspect and the power imbalance in the tutor–student relationship. They spoke of the importance of being assertive, following policies and procedures, and being factual rather than blaming. What was clear from the responses to my study was that it did not come naturally to therapists to maintain the firm professional trainer role and it wasn’t easy to bear the personal effects of dealing with conflict. There is a clear need for a considerable amount of resilience and experience in the role. As one participant wrote: ‘There is a part of me that doesn’t want to be in the more powerful position.’ Organisational context Doing the research, I began to have an image of a trainer on a unicycle on a high wire, pedalling furiously to keep up there and whizzing from the therapist side to the professional tutor/assessor/maintainer of standards side. What became apparent from this study is the need for a robust supporting framework so that the tutor does not topple off. Counselling tutors are not working in isolation – the success of conflict resolution depends on the environment in which the tutor works and on the structure of the course itself. Counsellor training involves supervisors, placement providers and, often, personal therapists. It became clear that all of these need to be pulling together in the same direction as the trainer. As one of the tutors said: ‘To have a sense that everybody involved with their [the students] training is moving in the same direction and singing from the same song sheet, I think is enormously helpful.’ Another participant described a situation where concerns about a student’s performance were not raised by their supervisor until near the end of their course, although the placement providers thought the student was doing well: ‘The placement providers became angry, siding as it were with the student and adding to the conflict that might otherwise have been more amicably resolved.’ This ‘pulling together’ was one of the main factors that determined whether conflicts were resolved smoothly and successfully. Sometimes decisions about students were determined by what the educational establishment decided, even if they went against counselling ethics and the standards of a course. One tutor found her college did not support her with a difficult student who was not following course guidelines: ‘The student set up her own counselling practice... instead of finding a placement. When I challenged her about this she complained to the college and accused me of harassment. The college could not see the problem as she was gaining the required hours to pass the course,’ she wrote. Often the student’s point of view would be given more weight than that of the tutors or the training on the programme: ‘They [the college authorities] bend over backwards to see the student’s point of view, sometimes in a way that feels unsupportive actually to the person’s development.’ Sometimes tutors were not allowed to encourage unsuitable students to leave the course, because that would have resulted in loss of income to the college: ‘We’re in a recession and we’ve got to keep bums on seats and all the rest and that’s just got worse and worse over the years.’ I have been in a course team where we were told that students could not be failed on grounds of being unfit to practise; the only way that the person could fail and not become a counsellor was if their academic work did not pass. One focus group member echoed this frustration: ‘If a student is not willing to reflect on self and is impervious to feedback from others, that’s not a good therapist, and something’s gone wrong if I am able to pass a student like that… I think we have problems with that when it comes to our manager ’cos she’s not got that background.’ Occasionally organisational policies and procedures were helpful to the course team. Exceptionally, one tutor had been supported by her manager: ‘I’ve always been supported (fairly and without collusion) by my line manager(s) so am lucky in this respect.’ Whatever the context, the individual tutor’s approach to the conflict was important in its successful management. Many of the participants talked about wanting to empathise and understand their students’ point of view and actively find out what was going on for the person. To do this participants tried hard to be fair and non-judgmental, to show genuine interest in the student and be willing to apologise if found to be at fault: ‘When people feel aggrieved, what they want even more than a head on a plate is to feel heard in their distress. So, “I’m sorry I did that. I can see so clearly how you felt belittled” can be very powerful.’ Feeling listened to might be all that is required and, as another tutor said: ‘I believe that if they are heard maybe I will be heard too.’ Dealing with conflict The participants in this study were enthusiastic about using the course group for conflict management. There was some wish to avoid tackling individual students directly, although to bring up some issues in a course group when they do not concern all members may be irksome to the rest. Some of my research participants suggested that group activities and group time could be used to promote reflection on behaviour and attitudes, with the trainer encouraging students to reflect on what is going on for them and their own part in the conflict. However this strategy can sometimes backfire: ‘I attempted to deal with the conflict within the group setting. This resulted in further conflict involving most other members of the group. My co-tutor stepped in – in support of me to help manage the situation – which resulted in the anger and distress being projected onto him. Eventually, the need to move on rather than dwell on the conflict became apparent, although this was difficult in terms of relationships between trainers and students.’ Using the conflict situation in group exercises as part of the course appeared to be a good way to promote learning. Some tutors were also keen on students challenging each other and being involved in assessment. The value of having a co-tutor during conflicts was particularly highlighted. As one participant wrote: ‘Having a co-tutor is very helpful as they can “hold” the group whilst something is being unpicked between a student and the other tutor. Also, if one of us is triggered by a student, the other tutor can act as a “reality check” – and also take on the main contact with that student, whilst the trigger itself gets sorted out in supervision etc.’ Conclusions This article has highlighted some of the key aspects of managing conflicts between tutors and students that emerged in my research: in particular the tension between the therapist and tutor dimensions of the trainer’s role and the significance of the course structure and organisational context. An important finding from the study is that there needs to be an integrated approach to conflict management, rather than a knee-jerk response. Although not suggested by the tutors, my view is that training providers may need educating about the requirements of counselling courses and the need to give the course team adequate support in managing their dual role. Students also need to understand what is expected of them from their participation in the course, and perhaps what to expect of their tutors. Returning to my jungle metaphor, I offer here a checklist for the tutor or course leaders about to embark on their latest educational expedition with a new cohort of students. Are the following elements in place? Does everyone have the same route map, including the students? Do you all know where you are going and the aims of the expedition? Is the back-up support there – eg co-tutors, team, supervisors, placement providers, therapists, training supervisor, own therapist? Are you confident that the funders/ supporters will not scupper the expedition or change the route at short notice? Has the expedition been thoroughly planned and potential difficulties and risks pre-empted? Are you prepared for encounters with wild animals and other likely hazards? Being involved in counsellor training is exciting and rewarding, but it can be an exhausting and emotionally hazardous process too. I hope the findings from my study will be helpful for those planning and running practitioner courses. Jayne Godward is a person-centred counsellor and supervisor, Senior Lecturer at Leeds Metropolitan University, and Manager and trainer at Yorkshire Counselling Training, Hull and Bradford. References
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