Being on the same side

I am writing in response to Elaine Davies’ Talking Point, ‘We are all on the same side’ (Therapy Today, July 2013).

While I feel sadness at her experiences, I wonder perhaps if they are partly due to the level of despair and frustration felt by many counsellors who, since the conception and growth of IAPT, have found themselves marginalised, dismissed, devalued and often, sadly, facing redundancy.

Being on the same side will only be possible when all therapists from all modalities are treated and respected equally. I share Alan Pope’s view in the same issue (‘The depths of depression’, Therapy Today, July 2013) that psychodynamic counselling and psychoanalytical psychotherapy have been sidelined by IAPT and NICE, and person-centred counselling has been almost wiped out.

I think I would prefer to cope with one delegate sniggering at a presentation than know NICE suggests clients choosing counselling should be warned of the uncertainty of effectiveness of counselling in the treatment of depression.

There is a wealth of research proving that it is the quality of the therapeutic relationship, the existence of healing through moments of meeting with an empathic fellow human being that promote enduring recovery, not the prescriptive delivery of interventions.

Horvath and Greenberg,1 Howey and Ormrod,2 Smith and Glass3 and Bordin4 all identify that a collaborative, therapeutic relationship provides the client with a safe environment in which to explore the self. The process of developing this kind of relationship may also capture the client’s key relationships, past and present.

Research by Norcross5 involving the analysis of thousands of studies of qualitative and quantitative reviews indicates that 75–80 per cent of clients entering psychotherapy show benefit. Research by Roijen6 suggests clients receiving counselling tend to be more satisfied with their treatment than clients receiving CBT. I am puzzled as to why this wealth of research has been studiously ignored in favour of CBT.

I personally became a victim of the removal of counselling from primary care trusts. I was made redundant from a counselling post in GP surgeries. Coping with the fear of financial loss and the sorrow of leaving a workplace in which I had built good relationships left me feeling angry and anxious. I found myself searching for employment and had no choice but to accept a trainee post as a psychological wellbeing practitioner (PWP) in an IAPT social care organisation.

I initially tried to embrace a return to university studies, but quickly realised that the concepts behind delivering low intensity CBT interventions did not resonate with my values as a therapist. Unfortunately I found the approach reductionist, medicalised and simplistic. Similarly to Elaine Davies’ experience of a tutor dismissing CBT, I experienced a tutor making it abundantly clear that counselling had no place in therapy, compared with CBT.

The majority of PWPs are university graduates in their early 20s, with little or no experience of mental health. They undertake a one day a week, one-year certificate course and on completion are deemed able to staff the front line. We were the first point of access for clients presenting with complex psychological symptoms. My background includes 15 years plus as an RMN psychiatric nurse in the NHS. I am also an accredited integrative counsellor with many years of experience in primary care. I felt equipped with the necessary skills to cope but many of my peers struggled. Assessing clients with high risk factors, presentations of addiction or complex enduring depression places demands on practitioners. My experience was that the wellbeing of PWPs held no priority over target achievement. As a PWP I had an expected target of eight to 10 client contacts per day. This left me struggling to adhere to the BACP Ethical Framework and, although I no longer work for that organisation, I still harbour feelings of guilt as to the quality of care I was able to give to the eighth client on each shift.

The wealth of knowledge and skills I gained on my two-year postgraduate diploma in integrative counselling was obviously academically superior to a one-year certificate course in delivering low intensity CBT interventions. Add to this the exacting standards of becoming BACP accredited and the need to secure many hours of clinical contact. And yet, on returning to a self-employed post in an IAPT mental health access service, counsellors were placed on a pay scale band 5. This is the same pay scale awarded to psychological wellbeing practitioners who, in effect, have learnt three basic manualised CBT intervention techniques. CBT therapists working alongside counsellors at step 3 are placed on band 7, counsellors on band 6. I am not particularly motivated by financial gain but fairness, equality and justice are important to me.

There may be responses citing ‘evidence-based IAPT courses’. The pay bias in favour of CBT began from the start of the IAPT roll out, relying only on research pertaining to CBT.

I have already cited the vast amount of research proving the effectiveness of a relational, psychodynamic approach to therapy. I wonder if Elaine Davies fully understands the deep sense of loss and devaluation felt by counsellors, at a personal and professional level.

I am extremely fortunate to have finally found a counselling post in a small IAPT team that is part of a reputable counselling organisation. I also go to work with a spring in my step. The ethos, ethics and values from the organisation are clearly counsellingorientated. Both counsellors and CBT therapists are heard, supported and respected. While targets are always a feature, they are not at the expense of the wellbeing of the workforce or client care.

I have many friends who are CBT therapists and I believe we each have a right to practise within whichever
field we choose; diversity can only be of benefit to clients, who should be able to choose whichever form of therapy they wish.

I take heart that the tide seems at last to be turning and counselling and psychotherapy appear to be regaining credibility as therapy equal to CBT.

Sharon Dixon, Integrative counsellor MBACP/UKCP (Accred)

References

1. Hovarth AO, Greenberg LS (eds). The working alliance: theory research and practice. New York: Wiley; 1994.
2. Howey L, Ormrod J. Personality disorder, primary care counselling and therapeutic effectiveness. Journal of Mental Health 2002; 11(2): 131–139.
3. Smith ML, Glass GV. Metaanalysis of psychotherapy studies. American Psychologist 1977; 32: 752–760.
4. Bordin ES. Theory and research on the therapeutic working alliance: new directions. In: Hovarth AO, Greenberg LS (eds). The working alliance: theory research and practice. New York: Wiley; 1994 (pp13–37).
5. Norcross JC (ed). Psychotherapy relationships that work (2nd ed). New York: Oxford University Press; 2011.
6. Hakkaart-van Roijen L, van Straten A, Al M, Rutten F, Donker M. Cost-utility of brief psychological treatment for depression and anxiety. British Journal of Psychiatry 2006; 188(4): 323–329.

Room for us all

I was saddened and annoyed to read Elaine Davies’ Talking point article ‘We are all on the same side’ (Therapy Today, July 2013) about the criticism she has faced as a CBT practitioner. My own view is that the counselling profession has a responsibility and a duty to effectively demonstrate that talking therapies work, not least when expecting taxpayers to foot the bill. It is not the fault of CBT professionals, who have done a splendid job of providing evidence to persuade budget holders to release their purse strings; rather it is the fault of the other therapeutic approaches for not being so active and persuasive in this regard. Perhaps they should use their envy to spur them into action!

A criticism levelled at CBT (which Davies raises) is that it is superficial. My limited understanding is that CBT can be immensely useful for more down-to-earth clients and some CBT practitioners I know of work with clients with chronic conditions in-depth for several years. Let us not forget that there are drawbacks to all our therapeutic approaches but surely there is a place and room for us all.

Indira Chima, Psychodynamic practitioner

No hope of paid work

August 2013 sees me enter my third year of registered unemployment since qualifying as a humanistic counsellor (PGDip) in 2011. Called to account on a fortnightly basis at the Job Centre, I am well supported by their staff, who constantly express surprise at my unchanging situation, although as a 50-year-old woman I am all too aware that my prospects for paid employment in any field remain extremely limited at best.

During this time I have maintained my commitment to voluntary counselling work for three local charitable organisations, grateful both for these opportunities and the richness of my experience. That clients with the most extenuating of personal difficulties continue their commitment with me must at the very least be a testament to my capability as a therapist. And that, above all else, is what keeps me going.

What continues to vex me, however, is the tacit lack of availability of paid posts in this field. So my question is this: how can it be ethical for universities and colleges to continue to offer training courses for counselling (as distinct from counselling skills) when there is clearly very little, if any, prospect of paid work in this field apart from private practice, where the ongoing costs of insurance, supervision, registration, advertising and professional development remain prohibitive?

Gail Miles MBACP (but perhaps not for much longer as I cannot afford my subscription)

Money and the medical model

Oh how I agree with Pete Sanders and his rail against DSM-5 (Talking Point, Therapy Today, June 2013). However I am not so confident that the seductive culture of funding following ‘evidence’ will not prove to be a stronger voice than our own.

Having studied in the US, where knowing the disorders listed in DSM-5 and being able to ‘diagnose them’ is part of the curriculum, and having practised in their ‘medically insured world’ where, in order to get your insurer to pay for your therapy, you have to have a diagnosable problem, I see how therapists have been forced into collusion with this system, often very much against their better judgment and ethical stance.

If a client needs help but cannot pay, what are they to do? Provide the required document for their insurer; help the client but sell their soul in the process? Therapists cannot work without pay but, in playing their part in this unhealthy industry, they assist it to continue and become further embedded as the norm.

We may believe ourselves to be sheltered from this because it is not medical insurers who hold the purse strings in the UK but it is often the medical model adherents within the health sector who do. Medical model diagnoses may indeed be ‘simply a form of evil’ but, when they are partnered with money, ‘the root of all evil’, we have a BIG problem!

Liz Cobb MBACP

Space for gods and spirits

I was interested to see the serious attention being paid to ‘Spirit-based healing in the Black diaspora’ in the article by Ray Moodley (Therapy Today, July 2013). I am very interested in Santeria myself, for example, and have a banner of Obatala hanging in my study!

But one very important point needs to be made, I think. There is a real difference between prepersonal (pre-rational, preconventional) spirituality, which is generally very narrow and fear-based (leading to the use of dubious expedients such as exorcism), and transpersonal spirituality, which is not based on fear at all but does have a space for gods, goddesses and spirits of various kinds. These transpersonal faiths have great usefulness, as Moodley points out, and are free from the dangers of the earlier, more superstitious approaches mentioned above.

Many people in the West do not make this basic distinction and therefore reject what they do not know, and this is a pity.

John Rowan

Pagan practices

I read Roy Moodley’s article ‘Spirit-based healing in the Black diaspora’ (Therapy Today, July 2013) with interest. While I can appreciate an article that brings these practices into the awareness of the counsellor and highlights the need for sensitivity around this subject, I felt Professor Moodley’s article went beyond that and instead sought to make these practices attractive to those of us living in the West.

I was concerned about the way in which Professor Moodley sought to make the practices of Voodoo, Shango and Orisha more acceptable by highlighting where they were used in conjunction with Western religions: namely Catholic, Jewish and, by implication of using the Bible, the Christian faith. However the article was very one- sided: Professor Moodley’s knowledge of traditional spiritual healing practices was well-researched but, sadly, his understanding of the Bible and the Christian faith was clearly less well understood, despite his ‘credentials’ of being brought up in the Pentecostal Church. Voodoo, understood as spiritual magic involving divination, animal sacrifice, conjuring and herbalism, uses practices very reminiscent of the worship of Baal and other pagan gods in the Old Testament. In the Old Testament, such practices angered God and he told His people to stay away from them: ‘... do not let your people practise fortune-telling or sorcery, or allow them to interpret omens or engage in witchcraft or cast spells or function as mediums or psychics or call forth the spirits of the dead. Anyone who does these things is an object of horror and disgust to the Lord’ (Deuteronomy 18 v10–12).

The Israelites were only under God’s protection when they obeyed His Word. When they were seduced by the worshipping of other gods then God’s wrath was poured out upon them. The Bible tells us not to have any part in these practices; therefore to suggest in any way that these practices are acceptable to God shows a lack of Biblical knowledge and a scant regard for Biblical teaching. The Bible tells us that Jesus is the way, the truth and the life, and that there is no other way to the Father except through Him. To suggest that Christianity can sit alongside any other faith goes against God’s Word.

This leads me to my uneasiness with the covert theme that we in the West, in being less accepting of these activities, are somehow less enlightened. I think the article would have been of more value had the author spent less time aligning these practices and Western beliefs and concentrated instead on the counsellor’s role when faced with a client who is a believer in these traditional practices. I have no issue in offering the core conditions to a client who is taking part in these practices but to accept these practices myself would compromise my Christian faith and I do not believe that this is required of me as a counsellor. As with all of my clients, I would be respectful and kind: ‘… if you have a gift for showing kindness to others, do it gladly,’ as Romans 12: 8 tells us.

To finish, in my opinion this article was poorly researched and a little judgmental of those less willing to accept these practices. It saddens me that the editor of Therapy Today was willing to give credence to such a piece.

Sharon Burke

Dangerous and evil

I read with interest Roy Moodley article on ‘Spirit-based healing in the Black diaspora’ (Therapy Today, July 2013). I love the extensive research Roy has done and his presentation of the case. I quite agree with him on the aspect that there is a place and a need for exploring the spiritual in counselling and psychotherapy as some client issues may be rooted in the spiritual.

However I do not agree with the way he puts all spirituality (Voodoo, Shango, Pentecostal or Apostolic Christian healing) together and assumes they are the same, because they are not. Voodoo and Shango and most of the traditional spiritual healings are dangerous and evil. I am pleased the West recognises this. Pentecostal and Apostolic Christian healing is from God and is good because Jesus who is alive is still healing today as he did in the Bible stories. I am speaking from my experience. If Roy wants to prove this, let him research into the clients healed by this different spirituality and the outcome of it in their lives.

Susan Abraham MBACP

Self-harm as a coping strategy

This is a letter of gratitude to Lynn Martin for her article ‘Self-harm: the solution, not the problem?’ (Therapy Today, July 2013). Lynn writes on the subject with a level of understanding and compassion that speaks directly to my experience.

However hard it may be to hear about, I agree with Lynn that, as therapists, we must work to understand the role that self-harm plays in the lives of our clients. Viewed as a coping strategy and a means of emotional release, to deny clients that option until they have more functional means embedded may be very counterproductive. Indeed, to effectively seek to ‘ban’ the option of self-harm runs the risk of perpetuating in the client the very sense of shame that is likely to drive the behaviour in the first place.

It can be very distressing to bear witness to clients’ pain when it is expressed in the form of self-harm, but that is what they most need. Perhaps if we are unable to bear it sufficiently to understand it, then the most congruent response is an honest and compassionate referral.

Barry McInnes

Bearing a child’s pain

I write to comment on the article by Joanna North ‘When parents’ aren’t good enough’ (Therapy Today, May 2013). While I agree with North’s assertion that the vast majority of children coming into the care system do so due to parents who fail to provide good-enough care, her attitude seems to lead to a minimising of the experiences of abuse and neglect that the child endured, and therefore fails to address well enough the help required by these children to come to terms with what has happened to them.

North talks about ‘treading carefully around the representations that a child may have of their abusing or less-than-good-enough parents’. While I accept that we should not immediately ride roughshod over the internal, idealised representations that a child holds of the often longed- for absent birth parent, it is these distorted idealisations that often prevent a child from coming to terms with the events of their early childhood, making better attachments to their new long-term parents, and moving towards healing and integration.

She also asserts that, as therapists, we should never ‘name and blame’ the parent responsible and certainly should not show strong reactions to the harm their hands have perpetrated and that to do so is to fall into a trap. But what sort of trap does she mean? While we should never give vent to vindictive blame, I would contend that it is vital to name the abusive acts of a maltreating parent as wrong, and show a child the appropriate emotional responses to these harmful experiences and the damaging behaviour that their parent has inflicted with deliberate or unconscious intent. Indeed, how else does a child learn that it is not alright to behave this way?

Her contention that in naming the experience ‘it could be helpful and accurate to say “your parents loved you but did not know the rules of being a parent or have the skills to look after you”’ simply fails to consider the experiences of abuse and neglect from the child’s point of view. Of course we know that birth parents’ own histories of early abuse, mental ill health, cognitive functioning and so on are often instrumental in their limited capacity to parent their children to a goodenough standard. But babies and growing infants cannot know this. When they are left for long periods of time hungry, distressed, not comforted, in soiled nappies; when their emotional world is not attended to with attunement and reciprocity; when the misattunements and absences or unpredictable responses of a parent leave them frightened, confused and uncontained, they are unable to process these painful and difficult emotional states. To suggest that a parent who maltreated their child for whatever reason, understandable or not, loved them really but just didn’t know the rules of being a parent is at best hollow and at worst a lie. For what love is it that behaves in this way?

Disabusing the child of the long-held idealised image of parents ‘who loved them really’ but treated them so badly is a slow and painful process. North believes that ‘re-writing the script’ by giving children a story of another child’s experience similar to their own may help to lessen the impact and ‘make the pill less bitter’. While it may encourage a child to know they are not alone, this practice runs the risk of avoiding the facts of the child’s actual experiences and is unlikely to help the child with the task of coming to terms with the details of their own story, so vital for their recovery.

Through many years of work, a colleague and I developed an approach that aims to do just that. This dyadic therapy seeks to convey to children a truthful narrative taken from official social services chronology and other documentation used to secure a care order and place children with long-term foster or adoptive parents. Having used this approach with a growing number of children it is clear that, while the process of hearing the painful, sometimes shocking facts of what happened to bring them into the care system is a hard one, and often resisted initially by the young person wanting to hold onto their idealised image of ‘all-good parents’, over time they become increasingly engaged
with the developing narrative, their behaviour in placement settles, and they experience relief at hearing the details that make sense of their removal from home and their life so far.

Lastly, ‘holding back until the child is ready’ may sometimes be the right approach, for instance if a child is not settled with long-term parents who will hold them through the process of learning the true details of their past, or going through particularly difficult transitions in school etc. But I believe that frequently the ‘holding back’ may come from the adults – social workers, foster or adoptive parents, therapists, mental health professionals and others, because the details of a child’s life are so shocking and we naturally wish to protect children from more pain. But these children have lived through the events we are striving to protect them from and what they need are adults who can bear the pain with them and not avoid the awful truth that their birth parents were not just ‘not-good-enough’ but often cruel, abusive, maltreating and in no way ‘loving’ in their behaviour towards them.

Katherine Green MA, MBACP (Accred) psychotherapist

Friendly neuroscience

Richard House’s letter (‘Seductions of neuroscience’ Letters, Therapy Today, July 2013) discouraging us from being informed by neuroscience is an embarrassment to this profession.

No one is asking you to put a brain scanner on your client’s head during their sessions; simply to be aware of new findings and recognise that knowledge, far from being dangerous as you suggest, could be of value. While you are right to advise people to think critically about research before rushing to conclusions, I fear that casually pushing aside all of neuroscience is worryingly ignorant. To disregard anything that a) proves the efficacy of therapy – which may lead to desperately needed funding for services – and b) could help clients, is simply unprofessional and close-minded.

I’m worried that your attitude abandons us to an outdated, out of touch, ‘hippy dippy’ healer image. As a newly qualified humanistic/integrative counsellor (with a keen interest in neuroscience AND existentialism), I fear this is exactly the kind of image that does nothing to further the industry or break the stigma of mental illness by encouraging people to seek help.

Please don’t be afraid of research – as Mick Cooper teaches us, the facts are friendly! Arguing about whether Carl Rogers would approve or not is pointless; neuroscience has come a long way since his day and I certainly feel it’s possible to keep person-centred values at the core of my work while learning about what goes on in the brain.

You talk about ethical responsibility; I feel it is yours to not immediately dismiss what may be of benefit to your clients. It is then in the skill of the therapist, when relevant and appropriate, to share knowledge with our clients in a meaningful way that might aid their process and recovery. Unlike you, I feel that knowledge is power – to shun neuroscience would leave us a less powerful force for the promotion of positive change in people’s lives.

Natalie Marshall-Shore

Scientific proof

I have literally just submitted my dissertation to complete my MA in psychotherapy and counselling, and am sitting down with a coffee, having cleaned my fridge, to open my July copy of Therapy Today. I am first saddened by Elaine Davies’ experiences of other practitioners (Talking point) and then amazed by the ferocity Richard House voices towards neuroscience (‘Seductions of neuroscience’ Letters). My stomach is now in a tight ball.

I have spent nine months exploring the phenomenon of ‘insight’ through a heuristic research process. I have been amazed by the neuroscientific developments that have substantiated for me the reality and trustworthiness of my felt experiences. This has empowered me to learn how I can improve the potential of the biological processes that exist when ‘in relationship’ with another; an awareness that the unconscious activity between two individuals can be equally detrimental as beneficial.

We cannot hide. This is what neuroscience is showing us: our work for the last 100 years has been appropriate; science has caught up. Now its explicit and ‘reductionist’ approach can be an adjunct to support us in the current climate where knowledge formed in this way (in my belief, too, not always a helpful one) is the tool currently used to divide resources – resources we need.

Knowledge comes in many guises. May I tentatively suggest it is we who limit its usefulness if we choose to ignore some of its presentations.

Emma Dunn, Student member BACP

Explaining the brain

I wanted to reply to Richard House’s letter ‘Seductions of neuroscience’ (Letters, Therapy Today, July 2013), to provide a few quick answers to his question: ‘What conceivable relevance can neuroscience have to a client and me when we are sitting together?’

As an integrative therapist, I sometimes draw on neuroscience to explain to clients how trauma can affect their brain and that the symptoms of intrusive images and hyperarousal (ie PTSD) can be a ‘normal’ response to an unnatural event. Similarly, clients suffering from panic attacks can be reassured that their brain is misrepresenting ‘threats’ to them, and that this process can be interrupted. I even draw on analogies to the brain sometimes ‘overheating with worry’, which leads to exhaustion and tiredness for depressed clients.

All of these seem to be of great relevance to the client, who is sometimes greatly relieved that they are ‘not going mad’ and that there is an explanation for the symptoms they are suffering. This is not to say it is a universal panacea, but I believe psycho-education has a role to play in 21st century therapy, when used with the right client at the right time.

Justin Havens MBACP. Visit www.oeeuk.com

Intellectual onanism

I should like to thank Richard House for his letter entitled ‘Seductions of neuroscience’ (Letters, Therapy Today, July 2013). It often seems to me that modern (particularly Western) man’s obsession with the brain and, by extension, his intellect is somewhat like the adolescent male’s obsession with his penis. Having discovered this wonderful organ, he comes to believe that it can solve all of his problems. The consequences are similarly devastating.

It might in fact be quite useful to consider whether the human race is currently passing through a sort of evolutionary adolescence: irresponsible, convinced of its indestructibility, convinced also that the technological products of its own cleverness are superior to the slow evolutionary qualities of its animal forebears; out of control, and in a constant state of war with its parent, nature.

It is questionable whether he will make it beyond adolescence and mature into some sort of creative adult. How might he achieve this, with no obvious mentor to guide him, having to reinvent every wheel entirely on his own; obsessed indeed with his technology to the point of addiction? All the hallmarks of addiction are there: the belief that repeating the same behaviour will bring about a different outcome; needing more and more to produce the same level of effect – look at the current maniacal rush for oil and gas; increasingly in pain as a consequence of his addiction; and in almost total denial. I have used the male pronoun, since this does seem to me to be a predominantly male aspect of humanity. That does not, though, I think, let women off the hook, since both sexes are heavily engaged in the same obsessive pursuit of power and control through the intellect.

It seems likely that our parent, planet earth, patient though she is, will eventually say: ‘Enough!’ Whether she then pushes us out of the family home entirely or offers us another choice remains to be seen. I have a feeling that we have already been offered choices all too often, and these may well run out.

On the other hand, there may be room for optimism. My own experience of addiction, both personal and other people’s, is that, in the period before real recovery can start, there is often an insane push to consume as much of the drug of choice as possible. It feels like a need to let go all control and to prove to oneself that the addiction just does not work. In AA it is known as rock bottom. Some who reach rock bottom survive to become some of the most remarkable people I have ever met. Others, of course, do not survive. Collapse, almost to the point of death, is often the only way through.

Watch this space?

William Johnston

Relevance of neuroscience

In his letter (‘Seductions of neuroscience’ Letters, Therapy Today, July 2013), Richard House poses the question: ‘What conceivable relevance can neuroscience have to a client and me when we’re sitting in the room together, trying to co-create a healing encounter?’

I originally trained as a person-centred counsellor and subsequently in sensorimotor psychotherapy and feel that neuroscience (or, as I prefer to call it, neurobiology) does have something to say to the existential, meaning- making experiences within the therapeutic relationship. I can only speak from my experience of pluralistically1 incorporating some of the new insights gained from this field into short- and long-term work, as a GP counsellor and in private practice.

I have found that the emerging understandings, particularly about the physiological drivers for our survival systems (which I believe form part of what Carl Rogers observed as the actualising tendency), can help to stabilise and reassure clients, thus opening up the possibility for change.

Some of my clients find their ‘phenomenological world’ and ‘external behaviour(s) and reactions’2 bewildering and problematic. They are unable to find the insight to change these habitual patterns and are so well defended that even the thought of change feels more threatening than their current situation, limiting their capacity to make use of the therapeutic relationship. But, according to Mick Cooper, these are among the ‘strongest predictors of outcomes’.3

Rogers refers to different forms of insight that the client experiences and defines them as ‘some relatively simple, [and] some highly complex and going to the root of the behaviour patterns of the individual.’4 I find that the psycho-education gleaned from neurobiology can aid this process of complex insight. First, it can re-assure the client that they are not mad, there is a physiological logic to their problematic behaviours (or symptoms). This often allows them to be more accepting of themselves. Second, the client starts to understand that change will only come from inside themselves. This fits well with the foremost principle of facilitating the self-direction and individual autonomy of the client,5 and relies on the client’s own powers for the therapeutic change.6 This in turn allows the elements of insight cited by Rogers to grow,4 and ‘the planning of new and more satisfying ways in which the self can adjust to reality’.4

I hope that my response encourages more curiosity about the applicable information that emerges from hard science in clinical laboratories.

Sally-Anne Bubbers MSc, Registered Member MBACP

References

1. Cooper M, McLeod J. Pluralistic counselling and psychotherapy. London, SAGE Publications Ltd; 2011.
2. Rogers CR. Some new challenges. American Psychologist 1973; 28 (5): 379-387.
3. Cooper M. Essential research findings in counselling and psychotherapy. London: SAGE Publications Ltd; 2008 (p156).
4. Rogers CR. The development of insight in the counselling relationship. Journal of Consulting Psychology 1944; VIII(6): 331–341. http://centerfortheperson.org/ pdf/development-of-insight-in- a-counseling-relationship.pdf
5. van der Veen F. Core principles of the person-centered approach. La Jolia, CA: Centre for Studies of the Person; 1998 (revised 2006). http://www.centerfortheperson.org/ pdf/core-principles-of-the-personcentered-approach.pdf
6. Rogers CR. Significant aspects of client-centered therapy. American Psychologist 1946; 1: 415–422.

Correction

I just wanted to send a correction to the article on Time and Temporality Therapy in June’s Therapy Today. The author writes that Rumi said that God is closer to a person than their jugular vein and references a book by Yoltas. This is not a quote written by Rumi, though he made reference to it in his poetry. This is a verse from the Quran, chapter 50, verse 16: ‘… and We have created humankind and We know what their souls whisper to them, and We are nearer to each person than their jugular vein.’ (My less than perfect translation!) Just wanted to let you know. Interesting article, thanks very much.

Joanna Moon UKCP, MBACP

Obituary: Mark Prever

It is with great sadness, disbelief and a deep sense of loss that I find myself writing Mark Prever’s obituary.

Mark was a well respected and much liked colleague, clinical supervisor and trainer whose presence within Open Door Youth Counselling in Birmingham brought a wealth of knowledge and generosity of spirit, combined with a great humanity.

For 23 years I shared a deep personal friendship with Mark. We also shared an exciting, complex and rewarding professional relationship as we worked closely to steer this wonderful organisation forward with a shared passion for the emotional and mental health and wellbeing of young people and the furtherance of the person-centred approach, both within and outside of Open Door.

Mark spent most of his adult life working in education. In his latter years he found the constraints of the educational establishment prevented him from working alongside young people in depth and in the person-centred way that he cherished so much. There will be many young people across the city who will have gained great insight and understanding of themselves through their encounters with Mark.

Mark’s great love was his dear daughter Miriam, who is about to embark on university life. I know how excited Mark was for her and how he was looking forward to guiding and supporting her through this experience. It is so sad that Miriam will not have her dad by her side.

In the words of our senior counselling practitioner: ‘Whenever I have thought about Mark Prever since his untimely passing earlier this year, I have experienced a kaleidoscope of memories and emotions. From the warm, comforting glow of having known him to the cold hollowness of disbelief at seeing his life cut so cruelly short. Even though his life ended prematurely, his presence and influence will remain permanently with us all at Open Door. Mark’s humility and humour have somehow transcended the tragedy of the loss and are now indelibly woven into the fabric of who we all are.’

Mark was an author, wrote many papers and gave numerous lectures on the subject of mental health. He was always generous with his knowledge and time.

In Mark’s own words, taken from a recent Open Door publication: ‘I am never quite sure how many years I have been associated with Open Door. What is clear however is the impact the Agency had on me both personally and professionally. I am a different person in so many ways from the “young” teacher who arrived here all those years ago. I cannot deny that the opportunity to work with young clients has been a real thrill and a reminder of why I entered this work in the 1990s. I work closely with Carmel on a range of ethical, professional and developmental matters and feel that my input is valued. In fact, I would state that, in terms of professional self-worth, it is Open Door that gives me what I need to feel that I can make a valued and lasting contribution.’

Carmel Mullan-Hartley and the Open Door Team