095 – Counselling Clients with Mental Health Issues

095 – Level Required for Qualification as a Counsellor – Working with Clients Who Have a Mental Health Diagnosis – Working with Sex Offenders

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In episode 95 of the Counselling Tutor Podcast, Ken Kelly and Rory Lees-Oakes clarify the study type and level required to become qualified as a counsellor. In ‘Practice Matters’, Rory looks at how to work with clients who have received a formal mental health diagnosis. Last, the presenters discuss working with sex offenders.

Level Required for Qualification as a Counsellor (starts at 1.55 mins)

What level of qualification needed to be able to describe yourself as a qualified counsellor is a frequent question in our Facebook group. Rory explains the UK’s National Qualifications Framework. In this, level 2 is the vocational equivalent of GCSE, level 3 of A level, level 4 of first-year undergraduate degree, level 5 of second-year undergraduate degree, level 6 of third-year undergraduate degree, level 7 of master’s degree, and level 8 of doctorate.

So does having a degree in counselling mean you are a qualified counsellor? Not necessarily, explains Rory. The two key measures of whether you are qualified are that:

The minimum qualification level for counsellors in the UK is level 4. Some people say that you must have level 5 to be able to work in private practice, but this is not true (though it may be helpful to do so). It is not possible to qualify as a counsellor through online study alone.

Although counselling is not a regulated profession in the UK, meaning that becoming registered is voluntary, both employers and the public know what they’re looking for and generally will seek to choose a counsellor who is a member of such a register. What’s more, you usually need to be registered with a professional body in order to get insurance as a qualified counsellor.

Working with Clients Who Have a Mental Health Diagnosis (starts at 13.51 mins)

In ‘Practice Matters’, Rory talks about how to work as a counsellor with clients who have received a formal mental health diagnosis from a medical practitioner. He compares the social and medical models, explaining that counselling is part of the former. This asserts that it is important to drop the label and see the person.

Rory advises that assessment (which is very different from judgement) should be ongoing, including evaluating whether or not psychological contact (vital for effective counselling) is in place. It is useful to understand what the diagnosis means to the person, and how they are when they are well and unwell. This can help the counsellor identify any decline in the client’s condition and take action as needed to help them access the support they need to get better again.

Ken recommends that listeners look at this highly relevant lecture on the different models of mental health.

Working with Sex Offenders (starts at 23.01 mins)

Being faced with a client who is a sex offender (especially, perhaps, paedophile or hebephile) is a common fear among trainee counsellors: could you do it?

Ken clarifies that we are talking here about people who have already been through the justice system; if a client reveals harm to others that the authorities are not aware of, then this would be a time when breaking confidentiality would be needed.

Ken and Rory put forward various views and tips on working with sex offenders:

  • Be aware of your own history. If this means that you really feel you just could not work with a client who had a record of sex offending, then make sure you tell your placement provider at the start. They should understand and respect this.
  • Of course, sex offending could be disclosed unexpectedly once therapy has started. Rory reports that one counsellor he knows found that once the therapeutic relationship had been established and she had begun to understand the person, she was able to work with a sex offender, continuing to offer him unconditional positive regard. This is another example of where seeing the person not the label is important.
  • Bear in mind that someone who is a sociopath (e.g. Jimmy Savile) will not be capable of change or remorse. But for most offenders, the part of them that offends is just that, and Ken describes the cycle of emotions (often including deep remorse) that they experience.
  • If you are working with a sex offender, it is especially important to do plenty of research and CPD, and to have high-quality supervision.
  • Above all, remember that your focus needs to be on the person, not the acts.