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PSY20001 Theories Of Counselling

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PSY20001 Theories Of Counselling

1 Download12 Pages / 2,924 Words

Course Code: PSY20001
University: Swinburne University Of Technology

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Country: Australia

Question:

Present an essay that critically reviews the current ethical debate concerning evidence based practice in counselling.

Answer:

Introduction
Evidence-based practice is associated with a scientist-practitioner model. Evidence-based practice requires that practitioners maintain high standards of accountability in their practice. It argued that in circumstances where there is valid research evidence, the evidence should be given priority in addressing the therapy (Aveyard & Sharp, 2013). Counseling profession has several values that guide its practice. These fundamental values are integral in informing evidence-based counseling (Dobson & Dobson, 2016). In counseling, it is paramount that a counselor respects the rights of the client and accords him/her the dignity. Further, in evidence-based counseling, the safety of the client and integrity of client-counselor relationship ought to be observed. Additionally, there is need to ensure that there is a high quality of professional knowledge and that such knowledge is applied effectively (Laska, Gurman, & Wampold, 2014). This essay is seeking to delineate the evidence-based practice in counseling.
Arguments For and Against Evidence-Based Practice in Counseling
Both objective and subjective parameters are evident in the evidence-based debate. These parameters are important in the provision of effective counseling services to diverse groups of clients (Gelber, McCullough, & Chervenak, 2016). The challenge faced by counselors is striking a balance between what is known and that which is not known in a more ethical and thoughtful manner. As such, when engaging in counseling, the overriding goal is to ensure that the interests of the clients are well taken care of (Runco, Taylor, & Helft, 2017). It suffices to mention that the viewpoint of a counselor may influence counseling, service development and research (Menon et al., 2016). The use of the evidence-based practice in counseling should reinforce the ethical considerations as far as a client is concerned. As such, it is always imperative to implement an evidence-based practice that respects the values and preferences of diverse clients. It is significant that counselors ought to learn how to supplement evidence-based practice with experiential attributes (Menon et al., 2016). The exclusive use of evidence-based practice may limit the scale and scope of outcomes in clients with diverse problems.
Several studies have established the efficacy of group, family, and individual counseling. There is strong evidence that points to the effectiveness of certain counseling models and practices as opposed to others (Menon et al., 2016). Additionally, there is need to match the effectiveness of certain practices to problems of clients as well as understanding the differential value (Blease, Lilienfeld, & Kelley, 2016). Understanding these concepts is central to evidence-based practice and preparation in counseling. There is evidence that specific theoretical models are not synonymous with the positive outcome (Runco, Taylor, & Helft, 2017). Therefore, various protocols of evidence-based counseling show differences in their effectiveness in solving the problems of the client Fisher, Arbeit, Dumont, Macapagal, & Mustanski, 2016). The evidence-based counseling protocols are systematic intervention models characterized by an extensive collection of effectiveness and efficacy in a multiple setting. These multiple settings entail various groups of clients, among counselors, and the general community (Hilty et al., 2016; Runco, Taylor, & Helft, 2017). In this regard, evidence-based counseling is very much effective in helping clients with diverse problems such as depression, anxiety disorders among other psychological disorders (Blease, Lilienfeld, & Kelley, 2016).
Additionally, the evidence-based counseling is paramount in enhancing the understanding of counselors given the problems of their clients (Runco, Taylor, & Helft, 2017). There is a plethora of literature that suggests that evidence-based practice is integral in counseling as it stresses majorly on empirical evidence (Menon et al., 2016). In this regard, evidence-based counseling has replaced traditional beliefs and pure theoretical underpinnings with evidence (Schiefele et al., 2016). Indeed, in evidence-based counseling, the counselors are bound to apply a broad range of scientific models with clinical experiences in addressing the numerous problems that are faced by clients (Schiefele et al., 2016; Gelber, McCullough, & Chervenak, 2016). In addition, there is evidence that suggests that evidence-based practice in counseling increases the effectiveness in dealing with clients’ problems. Further, evidence-based counseling is viewed as a force that is vital in solidifying the profession and setting the pace for evolution in counseling (Gelber, McCullough, & Chervenak, 2016).
It suffices to mention that there has been a concerted effort to find a proper model that can be applied in counseling. Several studies have argued that counseling in itself is effective; there is no best theoretical approach (Gelber, McCullough, & Chervenak, 2016; Menon et al., 2016; Quanbeck et al., 2016). Indeed, studies have shown that theoretical orientation has no major influence on the outcome of counseling (Blease, Lilienfeld, & Kelley, 2016). It is worth noting that research has pointed to a set of similar factors that constitutes adequate counseling. These factors that influence effective counseling are not necessarily based on the client, theoretical orientation, or the counselor (Gelber, McCullough, & Chervenak, 2016).
  A large amount of current theoretical research that describes these common factors shows a wide area that entails the supportive value in collaborative counseling relationship (Roberts et al., 20160; Gelber, McCullough, & Chervenak, 2016). The other factor that is critical in counseling is the value of learning (Menon et al., 2016). In the value of learning, one should be able to acquire skills and experience corrective emotional experiences (Blease, Lilienfeld, & Kelley, 2016). Additionally, much emphasis ought to be laid on successful experiences, behavioral regulation, mastery, and behavior change.
The field of counseling has undergone several changes and developments. Counseling has been integral in assisting individuals with social and psychological problems (Blease, Lilienfeld, & Kelley, 2016). The advent of evidence-based practice has significantly revolutionized the practice of counseling. Evidence-based practice is characterized by features such as task-structured interventions, use of manuals to guide practitioners on what ought to be done, and time-limited activities (Quanbeck et al., 2016).
The development of evidence-based practice has led to great achievements in the area of counseling. The application of evidence-based practice in counseling is fundamental because it stresses the need to conduct interventions and assessments based on the available evidence (Wu, Huang, Jackson, Su, & Morrow, 2016). Evidence-based practice is all about knowledge and curiosity. In evidence-based practice, knowledge remains central to effective counseling (Hooker, 2016). Knowledge is set to disapprove, approve, and inform the understanding of counselors in meeting the needs of their clients. There is a consensus that considering evidence in counseling is imperative (Menon et al., 2016; Roberts et al., 2016). The consideration of evidence in counseling should equally be informed by ethical or the moral duty as part of the practice (Fisher, Arbeit, Dumont, Macapagal, & Mustanski, 2016).
It is paramount to note that evidence-based practice in counseling provides the opportunity to integrate several issues in practice. It is imperative to mention that evidence-based practice enables counselors to apply on the best research that is anchored on efficacy in addressing the needs of clients (Gelber, McCullough, & Chervenak, 2016). For instance, the evidence is central to the determination of how particular interventions work better to yield good results. Evidence best practice also focuses on the effectiveness of interventions that are available to be used in managing challenges that clients’ experience (Doyle et al., 2016; Roberts et al., 2016). Further, there is evidence that strongly suggests that evidence-based practice aids in making sound judgment and acquisition of relevant expertise (Menon et al., 2016; Schiefele et al., 2016). Ethically, it is imperative to note that evidence-based practice ought to recognize the values of the client and any other inherent preferences. It further stresses that opinions of experts in counseling should only be treated as such and that they do not constitute facts (Schiefele et al., 2016; Gelber, McCullough, & Chervenak, 2016).
It is vital to point out that the evidence-based practice entails a thoughtful identification and compassionate application of a client’s problems preferences, and rights in drawing decisions to improve their lives. Several studies support the argument that evidence-based practice aids in cost cutting (Coady & Lehmann, 2016; Blease, Lilienfeld, & Kelley, 2016). Several counseling professionals opine that evidence-based practice is the fastest and inexpensive mode of intervention. However, other studies have argued that viewing the evidence based practice as a cost-cutting tool may result in the distortion of its appropriate use (Menon et al., 2016). It is vital to point out that the choice to be made between competing procedures is influenced by their respective effectiveness (Runco, Taylor, & Helft, 2017). Additionally, the expertise of the practitioner should be a matter of concern in the application of evidence-based practice (Laska, Gurman, & Wampold, 2014). The claim that evidence-based practice in counseling signals cost cutting should not be the only cause of evaluation (Hodgson et al., 2016; Gelber, McCullough, & Chervenak, 2016). The other aspects of evaluating evidence-based practice should focus on its benefits and effectiveness.
Another argument in support of evidence-based practice in counseling is the fact that the models for intervention can be changed or tailor made to suit specific clients (Laska, Gurman, & Wampold, 2014; Gelber, McCullough, & Chervenak, 2016). Therefore, the application of evidence-based practice in counseling is not rigid and do not treat a client as a mere object (Dobson & Dobson, 2016). There is need to allow clients to express their feelings and desire regarding the treatment procedure. Additionally, the evidence based practice can be applied to both individuals and groups.
However much there is a justification for using evidence-based practice in counseling, there is resistance too. Many scholars argue that this resistance is necessitated by misconceptions and misunderstandings (Doyle et al., 2016; Coady & Lehmann, 2016; Blease, Lilienfeld, & Kelley, 2016). These misunderstandings and misconceptions are closely linked to the ethical or moral issues of interest to the client (Aveyard & Sharp, 2013; Menon et al., 2016). Many scholars have argued that evidence-based practice disregards all clinical judgment. As a result, a counselor may not be in a position to apply any experience when handling a client. In this regard, the counselor is limited to the use of the predetermined outcomes from other studies (Gelber, McCullough, & Chervenak, 2016). These studies may not be necessarily similar to the case at hand.
Another misunderstanding and misconception that surrounds evidence-based counseling are that it prevents counselors from administering invalidated interventions (Gelber, McCullough, & Chervenak, 2016). According to Blease et al. (2016), the misconception and misunderstanding that evidence-based practice advice against the application of invalidated interventions is wrong. They assert that evidence-based practice requires that practitioners ought to seek the full consent of their clients before administering any intervention.
The strongest resistance to the use of evidence-based practice in counseling is that it focuses much on outcomes of controlled trials (Fisher et al., 2016). Evidence-based practice is objected on the basis that it does not adequately rely much on theoretical plausibility (Schiefele et al., 2016). Many studies have argued that evidence-based practice is not bad per se, but there is need to widen the definition so as to encompass theoretical plausibility and rigorous research based on evidence (Gelber, McCullough, & Chervenak, 2016).
Furthermore, it is argued that evidence-based practice cannot adequately provide answers to questions arising from practice and policy (Hilty et al., 2016). It is imperative to point out that public opinions often play a critical role in shaping and influencing the rational application of research evidence. Additionally, the evidence-based practice is criticized for ignoring the preferences and values of a client (Menon et al., 2016; Aveyard & Sharp, 2013). Indeed, in evidence-based practice, there are a predetermined set of activities and values that ought to be applied in the counseling process. In this regard, the client’s point of view is ignored. In essence, ignoring the client’s preferences and values may limit the efficacy and scope of practice (Roberts et al., 2016; Gelber, McCullough, & Chervenak, 2016).
Further, evidence-based practice is thought to limit the imagination of counselors as they are forced to stick to a particular line of thinking (Hooker, 2016). It suffices to point out that creativity is central in counseling and as such limiting counselors from applying other methods and procedures negatively affects the practice (Menon et al., 2016). There is a plethora of literature that argues that evidence-based practice limits counseling research. In circumstances where counselors rely solely on evidence-based practice; limited research is often realized (Gelber, McCullough, & Chervenak, 2016). In this regard, evidence-based practice confines counselors’ professional abilities. Several studies have criticized the application of evidence-based practice by focusing on the philosophical grounds. According to these scholars, the evidence-based practice does not fit or conform to the realities of contextualized and personalized practice (Doyle et al., 2016). Some studies have argued that evidence-based practice has inherent limitations associated with the methodology. These systematic reviews entail meta-analysis. Meta-analysis is critical in providing part of the evidence that is applied in the evidence-based practice (Fisher et al., 2016). Evidence-based practice in counseling becomes a challenge when there are competing interests and factors.
Additionally, there is the limitation of a shortage of evidence (Gelber, McCullough, & Chervenak, 2016). The evidence-based practice is anchored on the belief that the action of professionals ought to be dictated by the available evidence. It is vital to note that the best proof originates from studies and practices that are well-designed to produce the best results (Menon et al., 2016; Schiefele et al., 2016). The proponents of the evidence-based practice in counseling face the issue of availability of sufficient high-qualities studies that can adequate support evidence-based practice (Doyle et al., 2016). Indeed, few studies have examined the adequacy of the evidence to support evidence-based practice in counseling (Gelber, McCullough, & Chervenak, 2016). It is worth noting that the counselor is integral in establishing the evidence-based practice in counseling. Most studies have shown that there are numerous studies on the counselor. The need to train effective counselors who can sufficiently address the needs of clients is paramount (Doyle et al., 2016; Menon et al., 2016). Most researchers have indicated that there exists no evidence that counselors enhance their duties through being more self-aware, personal therapy, and learning more about themselves.
Conclusion
From the ensuing debate on application of evidence-based counseling, it is quite clear that arguments against it are shrouded in a lot of misconceptions and misunderstandings. It is paramount to point out that the use of evidence in counseling is critical in ascertain better interventions for use in patients. Ethically, patients or clients are supposed to be accorded the best care so that they can overcome their problems. The ethical debate on the viability of evidence-based counseling serves to widen the scope of operationalizing key concepts and issues in nursing. It suffices to mention that evidence-based counseling is instrumental in ensuring that counselors provided appropriate therapies that are guided by ethical or moral considerations. In a nutshell, it is vital that counselors acquaint themselves with the current research findings so as to ensure that their practice is anchored in sound rationale. This will be integral in the choice and application of various intervention in an ethical manner.
References
Aveyard, H., & Sharp, P. (2013). A Beginner’s Guide to Evidence-based Practice in Health and Social Care. McGraw-Hill Education (UK).
Blease, C. R., Lilienfeld, S. O., & Kelley, J. M. (2016). Evidence-based practice and psychological treatments: the imperatives of informed consent. Frontiers in psychology, 7.
Coady, N., & Lehmann, P. (Eds.). (2016). Theoretical perspectives for direct social work practice: A generalist-eclectic approach. Springer Publishing Company.
Dobson, D., & Dobson, K. S. (2016). Evidence-based practice of cognitive-behavioral therapy. Guilford Publications.
Doyle, D. L., Awwad, R. I., Austin, J. C., Baty, B. J., Bergner, A. L., Brewster, S. J., … & Hooker, G. W. (2016). 2013 Review and Update of the Genetic Counseling Practice Based Competencies by a Task Force of the Accreditation Council for Genetic Counseling. Journal of genetic counseling, 25(5), 868-879.
Fisher, C. B., Arbeit, M. R., Dumont, M. S., Macapagal, K., & Mustanski, B. (2016). Self-consent for HIV prevention research involving sexual and gender minority youth: Reducing barriers through evidence-based ethics. Journal of Empirical Research on Human Research Ethics, 11(1), 3-14.
Gelber, S. E., McCullough, L. B., & Chervenak, F. A. (2016). Ethical Dimensions of Counseling about the Clinical Management of Gestational Diabetes. American Journal of Perinatology, 33(13), 1262-1265.
Hilty, D. M., Yellowlees, P. M., Myers, K., Parish, M. B., & Rabinowitz, T. (2016). The Effectiveness of e-Mental Health: Evidence Base, How to Choose the Model Based on Ease/Cost/Strength, and Future Areas of Research. In e-Mental Health (pp. 95-127). Springer International Publishing.
Hodgson, J., Metcalfe, S., Gaff, C., Donath, S., Delatycki, M. B., Winship, I., … & Halliday, J. (2016). Outcomes of a randomised controlled trial of a complex genetic counselling intervention to improve family communication. European Journal of Human Genetics, 24(3), 356-360.
Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the lens of evidence-based practice in psychotherapy: a common factors perspective. Psychotherapy, 51(4), 467.
Menon, P., Nguyen, P. H., Saha, K. K., Khaled, A., Kennedy, A., Tran, L. M., … & Afsana, K. (2016). Impacts on Breastfeeding Practices of At-Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, and Community Mobilization: Results of Cluster-Randomized Program Evaluations in Bangladesh and Viet Nam. PLoS Med, 13(10), e1002159.
Quanbeck, A., Brown, R. T., Zgierska, A., Johnson, R., Robinson, J. M., & Jacobson, N. (2016). Systems consultation: protocol for a novel implementation strategy designed to promote evidence-based practice in primary care. Health Research Policy and Systems, 14(1), 8.
Roberts, M. C., Blossom, J. B., Evans, S. C., Amaro, C. M., & Kanine, R. M. (2016). Advancing the Scientific Foundation for Evidence-Based Practice in Clinical Child and Adolescent Psychology. Journal of Clinical Child & Adolescent Psychology, 1-14.
Runco, D. V., Taylor, J. F., & Helft, P. R. (2017). Ethical Barriers in Adolescent Oncofertility Counseling. Journal of Pediatric Hematology/Oncology, 39(1), 56-61.
Schiefele, A. K., Lutz, W., Barkham, M., Rubel, J., Böhnke, J., Delgadillo, J., … & Lambert, M. J. (2016). Reliability of therapist effects in practice-based psychotherapy research: A guide for the planning of future studies. Administration and Policy in Mental Health and Mental Health Services Research, 1-16.
Wu, B., Huang, X., Jackson, T., Su, D., & Morrow, S. L. (2016). Counselors’ Current Counseling Practice: A Qualitative Investigation in China. The Counseling Psychologist, 44(3), 306-330.

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