What is the National Board for Certified Counsellors?

Introduction

The National Board for Certified Counsellors, Inc. and Affiliates (NBCC) is an international certifying organisation for professional counsellors in the United States. It is an independent, not-for-profit credentialing organisation based in Greensboro, North Carolina. The purpose of the organisation is to establish and monitor a national certification system for professional counsellors, to identify certified counsellors, and to maintain a register of them.

NBCC has more than 66,000 certified counsellors across the US and in more than 40 countries. Its examinations for professional counsellors are used by all 50 states, the District of Columbia and Puerto Rico to license counsellors.

Brief History

In December 1979, the American Personnel and Guidance Association (APGA) Board of Directors approved a plan to create a generic counsellor certification registry. In February 1982, the APGA President chose the members of the first NBCC Board, and the board’s first meeting was in April 1982. In July 1982, NBCC was incorporated as a not-for-profit entity separate from APGA. The separation ensured an unbiased certification process and an assumption of liability on the part of NBCC.

The NBCC established and now monitors a national certification system, to identify for professionals and the public those counsellors who have voluntarily sought and obtained certification. Unlike other professional mental health entities such as the American Counselling Association (ACA), the American Psychological Association (APA), and the Association for Counsellor Education and Supervision (ACES), NBCC does not have members. Instead, NBCC sets its own policies and procedures for national certification in professional counselling, administers the National Counsellor Examination to applicants, and keeps a register of counsellors who achieve certification.

Since 2001, NBCC has worked to pass legislation adding licensed professional counsellors (LPC) and marriage and family therapists (MFT) to Medicare. Medicare is the largest health care programme in the United States and currently recognises psychiatrists, psychologists, clinical social workers and psychiatric nurses for outpatient mental health services, but does not reimburse LPCs or MFTs for behavioural health services. As a result, a client who sees an LPC or MFT has to immediately cease therapy at the age of 65, when the government mandates that they must leave their health insurance to enrol in Medicare. NBCC believes that this Medicare exclusion of LPCs and MFTs should be removed, because they can play an important role in a functioning mental health system by maximising the capacity of the behavioural health workforce.

Certifications

The certification programme recognises counsellors who have met predetermined standards in their training, experience, and performance on the National Counsellor Examination for Licensure and Certification (NCE).

National Certified Counsellor (NCC)

NBCC’s flagship certification is the National Certified Counsellor (NCC). The NCC is a generic certification for professional counsellors and does not designate a particular specialty area. Holding an NCC indicates that a counsellor is nationally board certified. There are currently over 63,000 NCCs in the US and many other countries.

The current requirements to become an NCC include:

  • A graduate degree in counselling (or one with a major in counselling) from a regionally accredited college or university.
  • At least 48 semester hours of graduate-level coursework, including at least one course in each of nine specified areas, as well as at least six semester hours of supervised field experience.
  • At least 3,000 hours of post-master’s counselling experience in an applied setting over a minimum of 24 months, 100 of which must be supervised by a qualified supervisor.
  • A passing score on the associated National Counsellor Exam (NCE).

After 01 January 2022, NCC applicants will be required to have a degree from a counsellor education programme accredited by the Council for Accreditation of Counselling and Related Educational Programmes (CACREP), which includes a minimum of 60 semester hours of coursework.

The NCC is the board certification for counsellors. It is not required for supervised or independent practice; it identifies counsellors who have voluntarily sought and met established professional standards, and who continue to fulfil requirements governing continuing education credits and certification renewal. Certification is not a substitute for state-mandated licensure. However, many states use the NCE examination as part of their licensing requirements.

Specialty Certifications

In addition to the NCC, NBCC administers three specialty certifications that each have the NCC credential as a prerequisite, along with other requirements.

  • Certified Clinical Mental Health Counsellor (CCMHC).
  • Master Addictions Counsellor (MAC).
  • National Certified School Counsellor (NCSC).

Affiliates and Divisions

Since its establishment in 1982, NBCC has expanded to include:

  • The Centre for Credentialing & Education (CCE):
    • Created in 1995, CCE provides practitioners and organisations with assessments, business support services, and credentialing in a variety of fields, including counselling supervision, coaching, distance counselling, and human services.
    • CCE manages the Mental Health Facilitator (MHF) programme, which educates community members and leaders in providing basic mental health care and resources to their neighbours, especially in locations where mental health care is difficult to access.
  • NBCC International (NBCC-I):
    • Created in 2003, NBCC-I’s purpose is to promote the counselling profession worldwide.
    • With a focus on cultural sensitivity and understanding, as well as public awareness of the meaning of quality in professional counselling, NBCC-I offers programmes and institutes all over the world. NBCC-I also manages the international portion of the MHF programme.
  • The NBCC Foundation (NBCCF):
    • Created in 2005, NBCCF uses scholarships, fellowships, and capacity-building grants to encourage counsellors and counsellors-in-training to pursue careers as professional counsellors serving high-priority populations.
    • Increasing access to mental health care in rural, military, and minority communities is a major focus for NBCCF.
  • The European Board for Certified Counsellors (EBCC):
    • Created in 2010, EBCC is the hub for NBCC-I’s work in Europe.
    • EBCC provides support for European countries that are developing their own professional counselling efforts.
  • The Professional Counsellor (TPC):
    • Published by NBCC since 2011, TPC is a peer-reviewed, open-access, academic journal.
    • It is published online in a continuous format, and covers a wide range of topics including: mental and behavioural health counselling; school counselling; career counselling; couple, marriage, and family counselling; counselling supervision; theory development; professional counselling ethics; international counselling and multicultural issues; programme applications; and integrative reviews from counselling and related fields.

Book: Principles and Practice of Grief Counselling

Book Title:

Principles and Practice of Grief Counselling.

Author(s): Darcy L. Harris and Howard R. Winokuer.

Year: 2019.

Edition: Third (3rd).

Publisher: Springer Publishing Company.

Type(s): Paperback and Kindle.

Synopsis:

This core introductory text, with a focus on clinical application, combines the knowledge and skills of counselling psychology with current theory and research in grief and bereavement. The third edition is updated to address issues related to the developmental aspects of grief, including grief in children and young people, grief as a lifespan concept, and grief in an increasingly aging demographic. It describes new therapeutic approaches and examines the neurological basis of grief as well as trauma from disruption and loss.

Also emphasized is the role of diversity, along with cultural considerations in grief counselling. Instructor’s resources include a Test Bank, Instructor’s Manual, and PowerPoint slides. User-friendly, while grounded in the latest research and theoretical constructs, the text offers such pedagogical aids as learning objectives, practice examples, glossary terms, and questions for reflection in each chapter. Above all, the book addresses grief counselling and support in a way that is informed and practical. The content explores concepts relevant to complicated grief, while differentiating the normal human experience of grief from mental disorders. Purchase includes digital access for use on mobile devices and computers.

Book: Assessment Procedures for Counsellors and Helping Professionals

Book Title:

Assessment Procedures for Counsellors and Helping Professionals.

Author(s): Carl Sheperis, Robert Drummond, and Karyn Jones.

Year: 2019.

Edition: Ninth (9th).

Publisher: Pearson.

Type(s): Paperback.

Synopsis:

A classic textbook for aspiring counsellors, now updated and expanded to improve its usefulness and relevance for practicing counsellors.

Since its first publication in 1988, Assessment Procedures for Counsellors and Helping Professionals has become a classic among assessment textbooks designed specifically for aspiring counsellors. Now in its 9th Edition, the text includes extensive changes to content and updating throughout, while maintaining its popular, easy-to-read format and continuing emphasis on assessment information that is most useful and relevant for school counsellors, marriage and family therapists, mental health counsellors, and other helping professionals. Throughout the text, readers get invaluable information and examples about widely used assessment instruments in order to become familiar with these well-known tests.

NOTE:

Before purchasing, check with your instructor to ensure you select the correct ISBN. Several versions of the MyLab(TM) and Mastering(TM) platforms exist for each title, and registrations are not transferable. To register for and use MyLab or Mastering, you may also need a Course ID, which your instructor will provide.

Used books, rentals, and purchases made outside of Pearson

If purchasing or renting from companies other than Pearson, the access codes for the MyLab or Mastering platform may not be included, may be incorrect, or may be previously redeemed. Check with the seller before completing your purchase.

Book: Encyclopaedia of Counselling

Book Title:

Encyclopaedia of Counselling: Master Review and Tutorial for the National Counsellor Examination, State Counselling Exams, and the Counsellor Preparation Comprehensive Examination.

Author(s): Howard Rosenthal.

Year: 2017.

Edition: Fourth (4th).

Publisher: Routledge.

Type(s): Hardcover, Paperback, and Kindle.

Synopsis:

With more questions and answers than any other edition, the Encyclopaedia of Counselling, Fourth Edition, is still the only book you need to pass the NCE, CPCE, and other counselling exams. Every chapter has new and updated material and is still written in Dr. Rosenthal’s lively, user-friendly style counsellors know and love. The book’s new and improved coverage incorporates a range of vital topics, including social media, group work in career counselling, private practice and non-profit work, addictions, neurocounselling, research trends, the DSM-5, the new ACA and NBCC codes of ethics, and much, much more.

Book: Encyclopaedia of Counselling

Book Title:

Encyclopaedia of Counselling: Master Review and Tutorial for the National Counsellor Examination, State Counselling Exams, and the Counsellor Preparation Comprehensive Examination.

Author(s): Howard Rosenthal.

Year: 2008.

Edition: Third (3rd).

Publisher: Routledge.

Type(s): Paperback.

Synopsis:

In the third edition of Howard Rosenthal’s best-selling test preparation guide for the National Counsellor Examination (NCE), students get more help than ever with an expanded section on marriage and family counselling, new material on web counselling, and updated material throughout. This resource now includes over 1,050 tutorial questions/answers and a new “Final Review and Last Minute Super Review Boot Camp” section. This guide is an ideal review tool for state licensing, the NCC credential, and preparation for written and oral boards. And because the new Counsellor Preparation Comprehensive Examination (CPCE), draws from the same subject areas, the Encyclopaedia is a perfect study guide for the CPCE as well. Written in a unique question/answer format, with a quick reference index, this is also an essential student reference volume for use in any counselling, social work, or human services course.

Book: Contemporary Psychotherapies for a Diverse World

Book Title:

Contemporary Psychotherapies for a Diverse World.

Author(s): Jon Frew and Michael D. Spiegler.

Year: 2012.

Edition: First (1ed).

Publisher: Routledge.

Type(s): Hardcover.

Synopsis:

This unique text is the first to provide an introduction to the theory and practice of the major theories of psychotherapy and, at the same time, illustrate how these approaches are dealing with the ever-increasing diversity of today’s clients. Frew and Spiegler have assembled the leading contemporary authorities on each theory to offer an insider’s perspective that includes exposure to the style and language used by adherents of the approach, which is not available in any other text. The history of each approach and the latest, cutting-edge theory and practice are integrated with an emphasis on an awareness of the needs of diverse non-majority clients, creating a comprehensive, practical, and invaluable text for any counselling theories course.

The major psychotherapeutic approaches are presented in roughly the chronological order in which they were developed, and each chapter follows the same basic format to ensure consistency throughout the text. Along with traditional theories, there are chapters on reality therapy, feminist therapy, and narrative therapy, and the chapter on ethics includes multicultural and feminist perspectives. Each chapter includes:

  • The origin and evolution of the theory.
  • Theoretical foundations and how the theory is manifested in practice.
  • An evaluation of the evidence for the theory’s success, limitations, blind spots, and challenges.
  • “The Author’s Journey,” in which authors describe what lead them to adopt their approach and how their own practice has evolved over time.
  • Multicultural competencies and their importance in the context of the theory.

Resources are available online for instructors to supplement the material in the text and include a test bank and PowerPoint lecture slides.

Book: Case Study Research in Counselling and Psychotherapy

Book Title:

Case Study Research in Counselling and Psychotherapy.

Author(s): John Mcleod.

Year: 2010.

Edition: First (1st).

Publisher: SAGE Publications Ltd.

Type(s): Hardcover, Paperback, and Kindle.

Synopsis:

Case-based knowledge forms an essential element of the evidence base for counselling and psychotherapy practice. This book provides the reader with a unique introduction to the conceptual and practical tools required to conduct high quality case study research that is grounded in their own therapy practice or training. Drawing on real-life cases at the heart of counselling and psychotherapy practice, John McLeod makes complex debates and concepts engaging and accessible for the trainees and practitioners at all levels, and from all theoretical orientations. Key topics covered in the book include:

  • The role of case studies in the development of theory, practice and policy in counselling and psychotherapy.
  • Strategies for responding to moral and ethical issues in therapy case study research.
  • Practical tools for collecting case data.
  • ′How-to-do-it′ guides for carrying out different types of case study.
  • Team-based case study research for practitioners and students.
  • Questions, issues and challenges that may have been raised for readers through their study.

Concrete examples, points for reflection and discussion, and recommendations for further reading will enable readers to use the book as a basis for carrying out their own case investigation.

All trainees in counselling, psychotherapy and clinical psychology are required to complete case reports, and this is the only textbook to cover the topic in real depth. The book will also be valuable to people who intend to use existing case studies to inform their practice, and it will help experienced practitioners to generate publishable case reports.

Book: A Concise Introduction to Existential Counselling

Book Title:

A Concise Introduction to Existential Counselling.

Author(s): Martin Adams.

Year: 2013.

Edition: First (1st).

Publisher: SAGE Publications Ltd.

Type(s): Hardcover, Paperback, and Kindle.

Synopsis:

A Concise Introduction to Existential Counselling is just that: a brief and accessible pocket guide to the underlying theory & practice of the existential approach.

Addressing everything a new trainee needs to know and do in a way that is entirely accessible and jargon-free, this book:

  • Provides a short history of the existential tradition.
  • Puts key concepts into contexts, showing how theory translates into practice.
  • Discusses issues in the therapeutic process.
  • Shows how to work effectively with whatever the client brings to the session.
  • Addresses the significance of existential thought in the wider world.

This book will be the perfect companion to new trainees looking to embark on their path to thinking and practicing existentially.

Martin Adams is a practitioner and supervisor in private practice and a Lecturer at the New School of Psychotherapy and Regents College, both in London.

What is Motivational Interviewing?

Introduction

Motivational interviewing (MI) is a counselling approach developed in part by clinical psychologists William R. Miller and Stephen Rollnick. It is a directive, client-centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence. Compared with non-directive counselling, it is more focused and goal-directed, and departs from traditional Rogerian client-centred therapy through this use of direction, in which therapists attempt to influence clients to consider making changes, rather than engaging in non-directive therapeutic exploration. The examination and resolution of ambivalence is a central purpose, and the counsellor is intentionally directive in pursuing this goal. MI is most centrally defined not by technique but by its spirit as a facilitative style for interpersonal relationship.

Core concepts evolved from experience in the treatment of problem drinkers, and MI was first described by Miller (1983) in an article published in the journal Behavioural and Cognitive Psychotherapy. Miller and Rollnick elaborated on these fundamental concepts and approaches in 1991 in a more detailed description of clinical procedures.

Overview

Motivational interviewing (MI) is a person-centred strategy. It is used to elicit patient motivation to change a specific negative behaviour. MI engages clients, elicits change talk and evokes patient motivation to make positive changes. For example, change talk can be elicited by asking the patient questions such as: “How might you like things to be different?” or “How does __ interfere with things that you would like to do?”

Unlike clinical interventions and treatment, MI is the technique where the interviewer (clinician) assists the interviewee (patient) in changing a behaviour by expressing their acceptance of the interviewee without judgement. By this, MI incorporates the idea that every single patient may be in differing stages of readiness levels and may need to act accordingly to the patient’s levels and current needs. Change may occur quickly or may take considerable time, depending on the client. Knowledge alone is usually not sufficient to motivate change within a client, and challenges in maintaining change should be thought of as the rule, not the exception. The incorporation of MI can help patients resolve their uncertainties and hesitancies that may stop them from their inherent want of change in relation to a certain behaviour or habit. At the same time, it can be seen that MI ensures that the participants are viewed more as team members to solve a problem rather than a clinician and patient. Hence, this technique can be attributed to a collaboration that respects sense of self and autonomy.

To be more successful at motivational interviewing, a clinician must have a strong sense of “purpose, clear strategies and skills for such purposes”. This ensures that the clinician knows what goals they are trying to achieve prior to entering into motivational interviewing. Additionally, clinicians need to have well-rounded and established interaction skills including asking open ended questions, reflective listening, affirming and reiterating statements back to the patient. Such skills are used in a dynamic where the clinician actively listens to the patient then repackages their statements back to them while highlighting what they have done well. In this way, it can improve their self-confidence for change.

Furthermore, at the same time the clinician needs to keep in mind the following five principles when practicing MI.

Express Empathy

This means to listen and express empathy to patients through the use of reflective listening. In this step, the clinician listens and presents ideas the patient has discussed in a different way, rather than telling the patient what to do. This hopes to ensure that the patient feels respected and that there are no judgments given when they express their thoughts, feelings and experiences but instead, shows the patient that the clinician is genuinely interested about the patient and their circumstances. This aims to strengthen the relationship between the two parties and ensures it is a collaboration, and allows the patient to feel that the clinician is supportive and therefore will be more willing to be open about their real thoughts.

Develop Discrepancy

This means to assist patients in developing discrepancies between the current self and what they want to be like in the future after a change has taken place. The main goal of this principle is to increase the patient’s awareness that there are consequences to their current behaviours. This allows the patient to realize the negatives aspects and issues the particular behaviour that MI is trying to change can cause. This realisation can help and encourage the patient towards a dedication to change as they can see the discrepancy between their current behaviour and desired behaviour. It is important that the patient be the one making the arguments for change and realise their discrepancies themselves. An effective way to do this is for the clinician to participate in active reflective listening and repacking what the patient has told them and delivering it back to them.

Avoid Arguments

During the course of MI the clinician may be inclined to argue with a patient, especially when they are ambivalent about their change and this is especially true when “resistance” is met from the patient. If the clinician tries to enforce a change, it could exacerbate the patient to become more withdrawn and can cause degeneration of what progress had been made thus far and decrease rapport with the patient. Arguments can cause the patient to become defensive and draw away from the clinician which is counterproductive and diminishes any progress that may have been made. When patients become a little defensive and argumentative, it usually is a sign to change the plan of attack. The biggest progress made towards behaviour change is when the patient makes their own arguments instead of the clinician presenting it to them.

Roll with Resistance

“Rolling with resistance” is now an outdated concept in MI; in the third edition of Miller & Rollnick’s textbook Motivational Interviewing: Helping People Change, the authors indicated that they had completely abandoned the word “resistance” as well as the term “rolling with resistance”, due to the term’s tendency to blame the client for problems in the therapy process and obscure different aspects of ambivalence. “Resistance”, as the idea was previously conceptualised before it was abandoned in MI, can come in many forms such as arguing, interrupting, denying and ignoring. Part of successful MI is to approach the “resistance” with professionalism, in a way that is non-judgmental and allows the patient to once again affirm and know that they have their autonomy and that it is their choice when it comes to their change.

Support Self-Efficacy

Strong self-efficacy can be a significant predictor of success in behaviour change. In many patients there is an issue of the lack of self-efficacy. They may have tried multiple times on their own to create a change in their behaviour (e.g. trying to cease smoking, losing weight, sleep earlier) and because they have failed it causes them to lose their confidence and hence lowers their self-efficacy. Therefore, it is clear to see how important it is for the patient to believe that they are self-efficient and it is the clinician’s role to support them by means of good MI practice and reflective listening. By reflecting on what the patient had told them, the clinician can accentuate the patient’s strengths and what they have been successful in (e.g. commending a patient who had stopped smoking for a week instead of straining on the fact they failed). By highlighting and suggesting to the patient areas in which they have been successful, this can be incorporated into future attempts and can improve their confidence and efficacy to believe that they are capable of change.

While there are as many differences in technique, the underlying spirit of the method remains the same and can be characterized in a few key points:

  • Motivation to change is elicited from the client, and is not imposed from outside forces.
  • It is the client’s task, not the counsellor’s, to articulate and resolve the client’s ambivalence.
  • Direct persuasion is not an effective method for resolving ambivalence.
  • The counselling style is generally quiet and elicits information from the client.
  • The counsellor is directive, in that they help the client to examine and resolve ambivalence.
  • Readiness to change is not a trait of the client, but a fluctuating result of interpersonal interaction.
  • The therapeutic relationship resembles a partnership or companionship.

Ultimately, practitioners must recognize that motivational interviewing involves collaboration not confrontation, evocation not education, autonomy rather than authority, and exploration instead of explanation. Effective processes for positive change focus on goals that are small, important to the client, specific, realistic, and oriented in the present and/or future.

Four Processes

There are four steps used in motivational interviewing. These help to build trust and connection between the patient and the clinician, focus on areas that may need to be changed and find out the reasons the patient may have for changing or holding onto a behaviour. This helps the clinician to support and assist the patient in their decision to change their behaviour and plan steps to reach this behavioural change. These steps do not always happen in this order.

Engaging

In this step, the clinician gets to know the patient and understands what is going on in the patient’s life. The patient needs to feel comfortable, listened to and fully understood from their own point of view. This helps to build trust with the patient and builds a relationship where they will work together to achieve a shared goal. The clinician must listen and show empathy without trying to fix the problem or make a judgement. This allows the patient to open up about their reasons for change, hopes, expectations as well as the barriers and fears that are stopping the patient from changing. The clinician must ask open ended questions which helps the patient to give more information about their situation, so they feel in control and that they are participating in the decision-making process and the decisions are not being made for them. This creates an environment that is comfortable for the patient to talk about change. The more trust the patient has towards the clinician, the more likely it is reduce resistance, defensiveness, embarrassment or anger the patient may feel when talking about a behavioural issue. Overall, the patient is more likely to come back to follow up appointments, follow an agreed plan and get the benefit of the treatment.

Focusing

This is where the clinician helps the patient find and focus on an area that is important to them, where they are unsure or are struggling to make a change. This step is also known as the “WHAT?” of change. The goal is for the clinician to understand what is important to the patient without pushing their own ideas on the patient. The clinician needs to ask questions to understand the reasons if and why the patient would be motivated to change and choose a goal to reach together. The patient must feel that they share the control with the clinician about the direction and agree on a goal. The clinician will then aim to help the patient order the importance of their goals and point out the current behaviours that get in the way of achieving their new goal or “develop discrepancy” between their current and desired behaviours. The focus or goal can come from the patient, situation or the clinician. There are three styles of focusing; directing, where the clinician can direct the patient towards a particular area for change; following, where the clinician let the patient decide the goal and be led by the patient’s priorities, and; guiding, where the clinician leads the patient to uncover an area of importance.

Evoking

In this step the clinician asks questions to get the patient to open up about their reasons for change. This step is also known as the “WHY?” of change. Often when a patient puts this into words it reinforces their reasons to change and they find out they have more reasons to change rather than to stay the same. Usually, there is one reason that is stronger than the others to motivate the patient to change their behaviour. The clinician needs to listen and recognise “change talk”, where the patient is uncovering how they would go about change and are coming up with their own solutions to their problems. The clinician should support and encourage the patient when they talk about ways and strategies to change, as the patient is more likely to follow a plan they set for themselves. When the patient is negative or is resisting change the clinician should “roll with resistance” where they do not affirm or encourage the negative points but highlight the ways and reasons the person has come up with to change. The clinician must resist arguing or the “righting reflex” where they want to fix the problem or challenge the patient’s negative thoughts. This comes across as they are not working together and causes the patient to resist change even more. The clinician’s role is to ask questions that guide the patient to come up with their own solution to change. The best time to give advice is if the patient asks for it, if the patient is stuck with coming up with ideas, the clinician can ask permission to give advice and then give details, but only after the patient has come up with their own ideas first. If the clinician focuses more on their own reasons they believe the patient should change this would not come across as genuine to the patient and this would reduce the bond they made in the engaging process.

Planning

In this step the clinician helps the patient in planning how to change their behaviour and encourages their commitment to change. This step is also known as the “HOW?” of change. The clinician asks questions to judge how ready the patient is to change and helps to guide the patient in coming up with their own step by step action plan. They can help to strengthen the patient’s commitment to changing, by supporting and encouraging when the patient uses “commitment talk” or words that show their commitment to change. In this step the clinician can listen and recognise areas that may need more work to get to the core motivation to change or help the patient to overcome uneasiness that is still blocking their behavioural change. In doing this, they help to strengthen the patients motivation and support that they are capable of achieving this goal on their own. The clinician should help the patient to come up with SMART goals which are; Specific, Measurable, Achievable, Relevant and Time bound. This helps to set benchmarks and measure how their behaviour has changed towards their new goal.

Adaptations

Motivational Enhancement Therapy

Motivational enhancement therapy is a time-limited four-session adaptation used in Project MATCH, a US-government-funded study of treatment for alcohol problems and the Drinkers’ Check-up, which provides normative-based feedback and explores client motivation to change in light of the feedback.

Motivational interviewing is supported by over 200 randomised controlled trials across a range of target populations and behaviours including substance abuse, health-promotion behaviours, medical adherence, and mental health issues.

Motivational Interviewing Groups

MI groups are highly interactive, focused on positive change, and harness group processes for evoking and supporting positive change. They are delivered in four phases:

  1. Engaging the group.
  2. Evoking member perspectives.
  3. Broadening perspectives and building momentum for change.
  4. Moving into action.

Behaviour Change Counselling

Behaviour change counselling (BCC) is an adaptation of MI which focuses on promoting behaviour change in a healthcare setting using brief consultations. BCC’s main goal is to understand the patient’s point of view, how they’re feeling and their idea of change. It was created with a “more modest goal in mind”, as it simply aims to “help the person talk through the why and how of change” and encourage behaviour change. It focuses on patient-centred care and is based on several overlapping principles of MI, such as respect for patient choice, asking open-ended questions, empathetic listening and summarizing. Multiple behaviour change counselling tools were developed to assess and scale the effectiveness of behaviour change counselling in promoting behaviour change such as the Behaviour Change Counselling Index (BECCI) and the Behaviour Change Counselling Scale (BCCS).

Behaviour Change Counselling Scale


The Behaviour Change Counselling Scale (BCCS) is a tool used to assess lifestyle counselling using BCC, focusing on feedback on the skill achieved. “Items of BCCS were scored on 1-7 Likert scales and items were tallied into 4 sub-scales, reflecting the 3 skill-sets: MI and readiness assessment, behaviour modification, and emotion management”.

The data obtained is then presented on: item characteristics, sub-scale characteristics, interrater reliability, test-retest reliability and construct validity.

Based on a study conducted by Vallis, the results suggest that BCCS is a potentially useful tool in assessing BCC and aid to training practitioners as well as assessing training outcomes.

Behaviour Change Counselling Index

The Behaviour Change Counselling Index (BECCI) is a BCC tool that assesses general practitioner behaviour and incites behaviour change through talking about change, encouraging the patient to think about change and respecting the patient’s choices in regards to behaviour change. BECCI was developed to assess a practitioner’s competence in the use of Behaviour Change Counselling (BCC) methods to elicit behaviour change. Used primarily for the use of learning practitioners in a simulated environment to practice and learn the skills of BCC. It “provides valuable information about the standard of BCC that practitioners were trained to deliver in studies of BCC as an intervention”. Rather than the result and response from the patient, the tool emphasizes and measures the practitioner’s behaviours, skills and attitude. Results from the study show that after receiving training in BCC, practitioners show great improvement based on BECCI. However, as BECCI has only been used in a simulated clinical environment, more study is required to assess its reliability in a real patient environment. Furthermore, it focuses heavily on practitioner behaviour rather than patient behaviour. Therefore, BECCI may be useful for trainers to assess the reliability and effectiveness of BCC skills but further research and use is required, especially in a real consultation environment.

Technology Assisted Motivational Interview

Technology Assisted Motivational Interview (TAMI) is “used to define adaptations of MI delivered via technology and various types of media”. This may include technological devices and creations such as computers, mobile phones, telephones, videos and animations. A review of multiple studies shows the potential effectiveness of the use of technology in delivering motivational interviewing consultations to encourage behaviour change. However, some limitations include: the lack of empathy that may be expressed through the use of technology and the lack of face-to-face interaction may either produce a positive or negative effect on the patient. Further studies are required to determine whether face-to-face consultations to deliver MI is more effective in comparison to those delivered via technology.

Limitations

Underlying Mental Health Conditions

Patients with an underlying mental illness present one such limitation to motivational interviewing. In a case where the patient suffers from an underlying mental illness such as depression, anxiety, bipolar disease, schizophrenia or other psychosis, more intensive therapy may be required to induce a change. In these instances, the use of motivational interviewing as a technique to treat outward-facing symptoms, such as not brushing teeth, may be ineffective where the root cause of the problem stems from the mental illness. When working with these patients, it is important to recognise that only so much can be done at certain levels. The treating therapists should, therefore, ensure the patient is referred to the correct medical professional to treat the cause of the behaviour, and not simply one of the symptoms.

Pre-Contemplation

Patients in the pre-contemplation stage of the stages of change present a further limitation to the model. If the patient is in this stage, they will not consider they have a problem and therefore are unlikely to be receptive to motivational interviewing techniques. It is important that motivational interviewers are well trained in the approach to be taken when handling these patients. Well intended messages can have the opposite effect of pushing the patient away or causing them to actively rebel. In these instances discussing how the issue may be affecting the patient must be handled very delicately and introduced carefully. Suggesting less harmful ways of dealing with the client’s issue and helping them recognize danger signs may be a better approach to plant the seed aiding their progression to the contemplation stage.

Motivation

Professionals attempting to encourage people to make a behavioural change often underestimate the effect of motivation. Simply advising clients how detrimental their current behaviour is and providing advice on how to change their behaviour will not work if the client lacks motivation. Many people have full knowledge of how dangerous smoking is yet they continue the practice. Research has shown that a client’s motivation to alter behaviour is largely influenced by the way the therapist relates to them.

Therapist/Client Trust

Clients who do not like or trust their health care professionals are likely to become extremely resistant to change. In order to prevent this, the therapist must take time to foster an environment of trust. Even when the therapist can clearly identify the issues at hand it is important to have the patient feels the session is collaborative and that they are not being lectured to. Confrontational approaches by well-meaning therapists will inhibit the process.

Time Limitations

Time limits placed on therapists during consultations also have the potential to impact significantly on the quality of motivational interviewing. Appointments may be limited to a brief or single visit with a patient; for example, a client may attend the dentist with a toothache due to a cavity. The oral health practitioner or dentist may be able to broach the subject of a behaviour change, such as flossing or diet modification but the session duration may not be sufficient when coupled with other responsibilities the health practitioner has to the health and wellbeing of the patient. For many clients, changing habits may involve reinforcement and encouragement which is not possible in a single visit. Some patients, once treated, may not return for a number of years or may even change practitioners or practices, meaning the motivational interview is unlikely to have sufficient effect.

Training Deficiencies

While psychologists, mental health counsellors, and social workers are generally well trained and practiced in delivering motivational interviewing, other health-care professionals are generally provided with only a few hours of basic training. Although perhaps able to apply the underpinning principles of motivational interviewing, these professionals generally lack the training and applied skills to truly master the art of dealing with the patient’s resistant statements in a collaborative manner. It is important that therapists know their own limitations and are prepared to refer clients to other professionals when required.

Group Treatment

Although studies are somewhat limited, it appears that delivering motivational interviewing, in a group may be less effective than when delivered one-on-one. Research continues into this area however what is clear is that groups change the dynamics of a situation and the therapist needs to ensure that group control is maintained and input from group members does not derail the process for some clients.

Applications

Motivational interviewing was initially developed for the treatment of substance abuse, but MI is continuously being applied across health fields and beyond that. The following fields have used the technique of MI.

Brief Intervention

Brief intervention and MI are both techniques used to empower behavioural change within individuals. Behavioral interventions “generally refer to opportunistic interventions by non-specialists (e.g. GPs) offered to patients who may be attending for some unrelated condition”. Due to speculation in the health industry the use of brief intervention has been deemed to be used too loosely and the implementation of MI is increasing rapidly.

Classroom Management

Motivational interviewing has been incorporated into managing a classroom. Due to the nature of MI where it elicits and evokes behavioural change within an individual it has shown to be effective in a classroom especially when provoking behaviour change within an individual. In association with MI, the classroom check-up method is incorporated which is a consultation model that addresses the need for classroom level support.

Coaching

Motivational interviewing has been implemented in coaching, specifically health-based coaching to aid in a better lifestyle for individuals. A study titled “Motivational interviewing-based health coaching as a chronic care intervention” was conducted to evaluate if MI had an impact on individuals health who were assessed as chronically ill. The study’s results showed that the group that MI was applied to had “improved their self-efficacy, patient activation, lifestyle change and perceived health status”.

Environmental Sustainability

Initially motivational interviewing was implemented and formulated to elicit behavioural change in individuals suffering from substance abuse. However, MI has been reformed and has multiple uses. One of these uses include of stabilising the surrounding environment of an individual. This is completed by allowing the individual to evoke behavioural change within themselves and elicit motivation to change certain habits, for example substance abuse. By motivating the individual, it allows them to maintain the environment surrounding them to eliminate factors of temptation. However, if relapse occurs it is normal and is bound to happen.

Mental Disorders

Motivational interviewing was originally developed by William R. Miller and Stephen Rollnick in the 1980s in order to aid people with substance abuse disorders. However, it has also been implemented to help aid in established models with mental disorders such as anxiety and depression. Currently an established model known as cognitive behavioural therapy (CBT) is being implemented to aid in these issues. Research suggests that with collaborating motivational interviewing and CBT has proved to be effective as they have both shown to be effective. A study was conducted as a randomised cluster trial that suggests that when MI was implemented it “associated with improved depressive symptoms and remission rate”. There is currently insufficient research papers to prove the effect of MI in mental disorders. However, it is increasingly being applied and more research is going into it.

Dual Diagnosis

Dual diagnosis can be defined as a “term that is used to describe when a person is experiencing both mental health problems and substance misuse”. Motivational interviewing is used as a preventative measure for individuals suffering from both a mental health issue and substance misuse due to the nature of MI eliciting behavioural change in individuals.

Problem Gambling

Gambling issues are on the rise and it is becoming a struggle for therapists to maintain it. Research suggests that many individuals “even those who actively seek and start gambling treatment, do not receive the full recommended course of therapy”. Motivational interviewing has been widely used and adapted by therapists to overcome gambling issues, it is used in collaboration with cognitive behavioural therapy and self-directed treatments. The goal of using MI in an individual who is having issues with gambling is to recognize and overcome those barriers and “increase overall investment in therapy by supporting an individual’s commitment to changing problem behaviours”.

Parenting

Motivational interviewing is implemented to evoke behavioural change in an individual. Provoking behavioural change includes the recognising of the issue from an individual. A research was conducted by utilising motivational interviewing to help promote oral regime and hygiene within children under the supervision of a parent. In this research the experimental group which was parents who received MI education in the form of a “pamphlet, watched a videotape, as well as received an MI counselling session and six follow-up telephone calls”. The mothers who had received the MI counselling session showed that “children in the MI group exhibited significantly less new caries (decayed or filled surfaces)” in contrast to the children in the control group. This suggests that the application of MI with parenting can significantly impact outcomes regarding the children of the parent.

Substance Dependence

Motivational interviewing was initially developed in order to aid people with substance abuse, specifically alcohol. Due to the results it displayed MI can be implemented into any substance abuse or dependence treatment. Research that was conducted utilised MI with a cocaine-detoxification programme. This research had found that out of the 105 randomly assigned patients, the randomly assigned group that underwent MI treatment indicated that “completers who received MI increased use of behavioural coping strategies and had fewer cocaine-positive urine samples on beginning the primary treatment”. This evidence suggests that the application of MI in substance dependent individuals has a positive impact in aiding the individual to overcome this issue.

A 2016 Cochrane review focused on alcohol misuse in young adults in 84 trials found no substantive, meaningful benefits for MI for preventing alcohol misuse or alcohol-related problems.

What is Counselling Psychology?

Introduction

Counselling psychology is a psychological specialty that encompasses research and applied work in several broad domains: counselling process and outcome; supervision and training; career development and counselling; and prevention and health. Some unifying themes among counselling psychologists include a focus on assets and strengths, person-environment interactions, educational and career development, brief interactions, and a focus on intact personalities.

Brief History

The term “counselling” is of American origin, coined by Carl Rogers, who, lacking a medical qualification was prevented from calling his work psychotherapy. In the US, counselling psychology, like many modern psychology specialties, started as a result of World War II. During the war, the US military had a strong need for vocational placement and training. In the 1940s and 1950s, the Veterans Administration created a specialty called “counselling psychology”, and Division 17 (now known as the Society for Counselling Psychology) of the APA was formed. The Society of Counselling Psychology unites psychologists, students and professionals who are dedicated to promote education and training, practice, scientific investigation, diversity and public interest in the field of professional psychology. This fostered interest in counsellor training, and the creation of the first few counselling psychology PhD programmes. The first counselling psychology PhD programmes were at the University of Minnesota; Ohio State University; University of Maryland, College Park; University of Missouri; Teachers College, Columbia University; and University of Texas at Austin.

In recent decades, counselling psychology as a profession has expanded and is now represented in numerous countries around the world. Books describing the present international state of the field include the Handbook of Counselling and Psychotherapy in an International Context; the International Handbook of Cross-Cultural Counselling; and Counselling Around the World: An International Handbook. Taken together these volumes trace the global history of the field, explore divergent philosophical assumptions, counselling theories, processes, and trends in different countries, and review a variety of global counsellor education programmes. Moreover, traditional and indigenous treatment and healing methods that may predate modern counselling methods by hundreds of years remain of significance in many non-Western and Western countries.

Employment and Salary

Counselling psychologists are employed in a variety of settings depending on the services they provide and the client populations they serve. Some are employed in colleges and universities as teachers, supervisors, researchers, and service providers. Others are employed in independent practice providing counselling, psychotherapy, assessment, and consultation services to individuals, couples/families, groups, and organisations. Additional settings in which counselling psychologists practice include community mental health centres, Veterans Administration medical centres and other facilities, family services, health maintenance organisations, rehabilitation agencies, business and industrial organisations and consulting within firms.

The amount of training required for psychologists differs based on the country in which they are practicing. Typically, a psychologist completes an Undergraduate Degree followed by 5-6 years of further study and/or training, leading to the Ph.D. While both psychologists and psychiatrists offer counselling, psychiatrists must possess a medical degree and thus are able to prescribe medication where psychologists are not.

Process and Outcome

Counselling psychologists are interested in answering a variety of research questions about counselling process and outcome. Counselling process refers to how or why counselling happens and progresses. Counselling outcome addresses whether or not counselling is effective, under what conditions it is effective, and what outcomes are considered effective – such as symptom reduction, behaviour change, or quality of life improvement. Topics commonly explored in the study of counselling process and outcome include therapist variables, client variables, the counselling or therapeutic relationship, cultural variables, process and outcome measurement, mechanisms of change, and process and outcome research methods. Classic approaches appeared early in the US in the field of humanistic psychology by Carl Rogers who identified the mission of counselling interview as “to permit deeper expression that the client would ordinarily allow himself”

Therapist Variables

Therapist variables include characteristics of a counsellor or psychotherapist, as well as therapist technique, behaviour, theoretical orientation and training. In terms of therapist behaviour, technique and theoretical orientation, research on adherence to therapy models has found that adherence to a particular model of therapy can be helpful, detrimental, or neutral in terms of impact on outcome.

A recent meta-analysis of research on training and experience suggests that experience level is only slightly related to accuracy in clinical judgement, Higher therapist experience has been found to be related to less anxiety, but also less focus. This suggests that there is still work to be done in terms of training clinicians and measuring successful training.

Client Variables

Client characteristics such as help-seeking attitudes and attachment style have been found to be related to client use of counselling, as well as expectations and outcome. Stigma against mental illness can keep people from acknowledging problems and seeking help. Public stigma has been found to be related to self-stigma, attitudes towards counselling, and willingness to seek help.

In terms of attachment style, clients with avoidance styles have been found to perceive greater risks and fewer benefits to counselling, and are less likely to seek professional help, than securely attached clients. Those with anxious attachment styles perceive greater benefits as well as risks to counselling. Educating clients about expectations of counselling can improve client satisfaction, treatment duration and outcomes, and is an efficient and cost-effective intervention.

Counselling Relationship

The relationship between a counsellor and client is the feelings and attitudes that a client and therapist have towards one another, and the manner in which those feelings and attitudes are expressed. Some theorists have suggested that the relationship may be thought of in three parts: transference and countertransference, working alliance, and the real – or personal – relationship. Other theorists argue that the concepts of transference and countertransference are outdated and inadequate.

Transference can be described as the client’s distorted perceptions of the therapist. This can have a great effect on the therapeutic relationship. For instance, the therapist may have a facial feature that reminds the client of their parent. Because of this association, if the client has significant negative or positive feelings toward their parent, they may project these feelings onto the therapist. This can affect the therapeutic relationship in a few ways. For example, if the client has a very strong bond with their parent, they may see the therapist as a father or mother figure and have a strong connection with the therapist. This can be problematic because as a therapist, it is not ethical to have a more than “professional” relationship with a client. It can also be a good thing, because the client may open up greatly to the therapist. In another way, if the client has a very negative relationship with their parent, the client may feel negative feelings toward the therapist. This can then affect the therapeutic relationship as well. For example, the client may have trouble opening up to the therapist because they lack trust in their parent (projecting these feelings of distrust onto the therapist).

Another theory about the function of the counselling relationship is known as the secure-base hypothesis, which is related to attachment theory. This hypothesis proposes that the counsellor acts as a secure base from which clients can explore and then check in with. Secure attachment to one’s counsellor and secure attachment in general have been found to be related to client exploration. Insecure attachment styles have been found to be related to less session depth than securely attached clients.

Cultural Variables

Counselling psychologists are interested in how culture relates to help-seeking and counselling process and outcome. Standard surveys exploring the nature of counselling across cultures and various ethnic groups include Counselling Across Cultures by Paul B. Pedersen, Juris G. Draguns, Walter J. Lonner and Joseph E. Trimble, Handbook of Multicultural Counseling by Joseph G. Ponterotto, J. Manueal Casas, Lisa A. Suzuki and Charlene M. Alexander and Handbook of Culture, Therapy, and Healing by Uwe P. Gielen, Jefferson M. Fish and Juris G. Draguns. Janet E. Helms’ racial identity model can be useful for understanding how the relationship and counselling process might be affected by the client’s and counsellor’s racial identity. Recent research suggests that clients who are Black are at risk for experiencing racial micro-aggression from counsellors who are White.

Efficacy for working with clients who are lesbians, gay men, or bisexual might be related to therapist demographics, gender, sexual identity development, sexual orientation, and professional experience. Clients who have multiple oppressed identities might be especially at-risk for experiencing unhelpful situations with counsellors, so counsellors might need help with gaining expertise for working with clients who are transgender, lesbian, gay, bisexual, or transgender people of colour, and other oppressed populations.

Gender role socialisation can also present issues for clients and counsellors. Implications for practice include being aware of stereotypes and biases about male and female identity, roles and behaviour such as emotional expression. The APA guidelines for multicultural competence outline expectations for taking culture into account in practice and research.

Counselling Ethics and Regulation

Perceptions on ethical behaviours vary depending upon geographical location, but ethical mandates are similar throughout the global community. Ethical standards are created to help practitioners, clients and the community avoid any possible harm or potential for harm. The standard ethical behaviours are centred on “doing no harm” and preventing harm.

Counsellors cannot share any confidential information that is obtained through the counselling process without specific written consent by the client or legal guardian except to prevent clear, imminent danger to the client or others, or when required to do so by a court order. Insurance companies or government programmes will also be notified of certain information about your diagnosis and treatment to determine if your care is covered. Those companies and government programmes are bound by HIPAA to keep that information strictly confidential.

Counsellors are held to a higher standard than most professionals because of the intimacy of their therapeutic delivery. Counsellors are not only to avoid fraternising with their clients. They should avoid dual relationships, and never engage in sexual relationships.

Counsellors are to avoid receiving gifts, favours, or trade for therapy. In some communities, it may be avoidable given the economic standing of that community. In cases of children, children and the mentally handicapped, they may feel personally rejected if an offering is something such as a “cookie”. As counsellors, a judgement call must be made, but in a majority of cases, avoiding gifts, favours, and trade can be maintained.

The National Board for Certified Counsellors states that counsellors “shall discuss important considerations to avoid exploitation before entering into a non-counselling relationship with a former client. Important considerations to be discussed include amount of time since counselling service termination, duration of counselling, nature and circumstances of client’s counselling, the likelihood that the client will want to resume counselling at some time in the future; circumstances of service termination and possible negative effects or outcomes.”

Outcome Measurement

Counselling outcome measures might look at a general overview of symptoms, symptoms of specific disorders, or positive outcomes, such as subjective well-being or quality of life. The Outcome Questionnaire-45 is a 45-item self-report measure of psychological distress. An example of disorder-specific measure is the Beck Depression Inventory. The Quality of Life Inventory is a 17-item self-report life satisfaction measure.

Process and Outcome Research Methods

Research about the counselling process and outcome uses a variety of research methodologies to answer questions about if, how, and why counselling works. Quantitative methods include randomly controlled clinical trials, correlation studies over the course of counselling, or laboratory studies about specific counselling process and outcome variables. Qualitative research methods can involve conducting, transcribing and coding interviews; transcribing and/or coding therapy sessions; or fine-grain analysis of single counselling sessions or counselling cases.

Training and Supervision

Professional Training Process

Counselling psychologists are trained in graduate programmes. Almost all programmes grant a PhD, but a few grant a Psy.D. or Ed.D. Most doctoral programmes take 5-6 years to complete. Graduate work in counselling psychology includes coursework in general psychology and statistics, counselling practice, and research. Students must complete an original dissertation at the end of their graduate training. Students must also complete a one-year full-time internship at an accredited site before earning their doctorate. In order to be licensed to practice, counselling psychologists must gain clinical experience under supervision, and pass a standardised exam.

Australia

In Australia, counselling psychology programmes are accredited by the Australian Psychology Accreditation Council (APAC). To become registered as a counselling psychologist, one must meet the criteria for the area of practice endorsement. This includes an undergraduate degree in the science of psychology, an Honours degree or Postgraduate Diploma in Psychology, and a Master’s or Doctorate degree in counselling psychology. Graduates must then complete a registrar programme to obtain an area of practice endorsement and use the title counselling psychologist. A substantial component of this master’s degree is dedicated to individual psychotherapy, family and couples therapy, group therapy, developmental theory and psychopathology.

Training Models and Research

Counselling psychology includes the study and practice of counsellor training and counsellor supervision. As researchers, counselling psychologists may investigate what makes training and supervision effective. As practitioners, counselling psychologists may supervise and train a variety of clinicians. Counsellor training tends to occur in formal classes and training programmes. Part of counsellor training may involve counselling clients under the supervision of a licensed clinician. Supervision can also occur between licensed clinicians, as a way to improve clinicians’ quality of work and competence with various types of counselling clients.

As the field of counselling psychology formed in the mid-20th century, initial training models included Robert Carkuff’s human relations training model, Norman Kagan’s Interpersonal Process Recall, and Allen Ivey’s micro-counselling skills. Modern training models include Gerard Egan’s skilled helper model, and Clara E. Hill’s three-stage model (exploration, insight, and action). A recent analysis of studies on counsellor training found that modelling, instruction, and feedback are common to most training models, and seem to have medium to large effects on trainees.

Supervision Models and Research

Like the models of how clients and therapists interact, there are also models of the interactions between therapists and their supervisors. Edward S. Bordin proposed a model of supervision working alliance similar to his model of therapeutic working alliance. The Integrated Development Model considers the level of a client’s motivation/anxiety, autonomy, and self and other awareness. The Systems Approach to Supervision views the relationship between supervisor and supervised as most important, in addition to characteristics of the supervisor’s personal characteristics, counselling clients, training setting, as well as the tasks and functions of supervision. The Critical Events in Supervision model focuses on important moments that occur between the supervisor and supervised.

Problems can arise in supervision and training. First, supervisors are liable for malpractice. Also, questions have arisen as far as a supervisor’s need for formal training to be a competent supervisor. Recent research suggests that conflicting, multiple relationships can occur between supervisors and clients, such as that of the client, instructor, and clinical supervisor. The occurrence of racial micro-aggression against Black clients suggests potential problems with racial bias in supervision. In general, conflicts between a counsellor and his or her own supervisor can arise when supervisors demonstrate disrespect, lack of support, and blaming.

Vocational Development and Career Counselling

Vocational Theories

There are several types of theories of vocational choice and development. These types include trait and factor theories, social cognitive theories, and developmental theories. Two examples of trait and factor theories, also known as person-environment fit, are Holland’s theory and the Theory of Work Adjustment.

John Holland hypothesized six vocational personality/interest types and six work environment types:

  • Realistic;
  • Investigative;
  • Artistic;
  • Social;
  • Enterprising; and
  • Conventional.

When a person’s vocational interests match his or her work environment types, this is considered congruence. Congruence has been found to predict occupation and college major.

The Theory of Work Adjustment (TWA), as developed by René Dawis and Lloyd Lofquist, hypothesizes that the correspondence between a worker’s needs and the reinforced systems predicts job satisfaction, and that the correspondence between a worker’s skills and a job’s skill requirements predicts job satisfaction. Job satisfaction and personal satisfaction together should determine how long one remains at a job. When there is a discrepancy between a worker’s needs or skills and the job’s needs or skills, then change needs to occur either in the worker or the job environment.

Social Cognitive Career Theory (SCCT) has been proposed by Robert D. Lent, Steven D. Brown and Gail Hackett. The theory takes Albert Bandura’s work on self-efficacy and expands it to interest development, choice making, and performance. Person variables in SCCT include self-efficacy beliefs, outcome expectations and personal goals. The model also includes demographics, ability, values, and environment. Efficacy and outcome expectations are theorised to interrelate and influence interest development, which in turn influences choice of goals, and then actions. Environmental supports and barriers also affect goals and actions. Actions lead to performance and choice stability over time.

Career development theories propose vocational models that include changes throughout the lifespan. Donald Super’s model proposes a lifelong five-stage career development process. The stages are growth, exploration, establishment, maintenance, and disengagement. Throughout life, people have many roles that may differ in terms of importance and meaning. Super also theorised that career development is an implementation of self-concept. Gottfredson also proposed a cognitive career decision-making process that develops through the lifespan. The initial stage of career development is hypothesized to be the development of self-image in childhood, as the range of possible roles narrows using criteria such as sex-type, social class, and prestige. During and after adolescence, people take abstract concepts into consideration, such as interests.

Career Counselling

Career counselling may include provision of occupational information, modelling skills, written exercises, and exploration of career goals and plans. Career counselling can also involve the use of personality or career interest assessments, such as the Myers-Briggs Type Indicator, which is based on Carl Jung’s theory of psychological type, or the Strong Interest Inventory, which makes use of Holland’s theory. Assessments of skills, abilities, and values are also commonly assessed in career counselling.

Professional Journals

In the United States, the premier scholarly journals of the profession are the Journal of Counselling Psychology and The Counselling Psychologist.

In Australia, counselling psychology articles are published in the counselling psychology section of the Australian Psychologist.

In Europe, the scholarly journals of the profession include the European Journal of Counselling Psychology (under the auspices of the European Association of Counselling Psychology) and the Counselling Psychology Review (under the auspices of the British Psychological Society). Counselling Psychology Quarterly is an international interdisciplinary publication of Routledge (part of the Taylor & Francis Group).