Healthcare Counselling and Psychotherapy Journal, January 2019
For counsellors and psychotherapists working in healthcare

From the editor

As we begin 2019, we find ourselves living in an environment shaped by uncertainty: uncertainty over our future relationship with the European Union, over our financial stability, job security and – for some – even security about whether they will remain in this country.

These concerns will affect us and our clients, and cannot help but be present in our consulting rooms. We can only just begin to comprehend the potential impact of this uncertain environment on the incidences of depression, anxiety and workplace stress. The way in which each of us handles these challenges will depend on our own histories, our emotional resilience and our psychological flexibility.

In the lead article in this issue, Pat Bond suggests that, when we treat clients with depression and anxiety, we need to pay greater attention to exploring whether there is any underlying childhood trauma. She suggests that, in short-term therapy, the traumatic origins of mental illness may often be overlooked. The result is that we treat the symptom rather than the cause, and therefore do not help the client to recover in the long term. This can prove a particular challenge in the NHS system, in which strict protocols, budget constraints and time limits may prevent therapists from being able to engage in a deeper exploration of client difficulties. Nevertheless, even a simple acknowledgement of the trauma can be an important step. As Pat stresses, the importance of allowing a client to tell their story cannot be overestimated.

As a psychotherapist, one of the key issues that I have found myself grappling with over the past year has been the implications of the General Data Protection Regulation (GDPR) for my practice. I was therefore particularly grateful to Barbara Mitchels and David Membrey for their comprehensive article on GDPR and its relevance to counsellors and psychotherapists. GDPR came into force in May 2018; however, there has been some uncertainty about the concrete changes that the legislation requires therapists to make in practice. This article provides practical information about the way in which data need to be handled under the new legislation. Many aspects of the implementation of GDPR are still unclear, and will remain so until additional guidance and case law are in place. In the absence of this, the authors highlight the importance of transparency with clients, even when we are not completely clear about how we should implement the legislation.

GDPR is just one of many issues that may contribute to the increasing anxiety levels experienced by many staff working in NHS settings. Time constraints, increasing levels of bureaucracy, and the pressures of measuring outcomes can all compound workplace stress. Reducing stress is therefore a key challenge for all NHS trusts. Dr Paivi Lappalainen and his colleagues write about how acceptance and commitment therapy (ACT) has been used successfully to tackle workplace stress in a number of NHS trusts. The Shift Your Stress programme is based on the premise that wellbeing is a skill that can be enhanced. The online programme focuses on the creation of psychological flexibility, so that participants can cope with difficult thoughts and emotions, and work towards reaching their goals and living in line with their values. The programme consists of simple exercises that can be implemented in day-to-day life, such as learning to be present in the moment.

One year ago, Michelle Nicholson wrote an article for this journal, highlighting the debilitating effects of severe pregnancy sickness, or hyperemesis gravidarum. In a follow-up piece, she now highlights the practical ways in which counselling might help women experiencing severe pregnancy sickness. She sets out a series of psychotherapeutic tasks that can act as a best practice guide when working with this client group. Her recommendations cover a wide range of areas, including developing coping strategies, working with relationships, psychoeducation, supporting the transition to motherhood, creating a self-care plan and expanding support networks.

Finally, a new feature in this issue of the journal is an interview with one of our members, in order to demonstrate the rich variety and substance of the division’s work. This issue features Rachel Johnston, a member of the BACP Healthcare Executive and Director of Connect2Counselling CIC in Belfast. Rachel talks about some of the challenges currently facing the counselling profession in Northern Ireland, arguably the area of our four nations most plagued by uncertainty at present – both as a result of Brexit and the lack of a government. Do let me know if you would like your work, or the work of a colleague, to feature in a future issue.

Joanna Benfield, Editor
hcpj.editorial@bacp.co.uk

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