Community Counselling or Clinical Counselling?

An Interview with Malachy Kinnerney, ACCEPT

[Association for Community Counselling, Education & Psychological Training]

July 1994

Community Counselling

The main focus of ACCEPT, as the name implies, is towards the area of community counselling and voluntary counselling. Heretofore some of the people we would train either overtly or covertly want to get into private counselling, so much so that we have now, in our latest brochure, spelt out that we are not involved in professional, clinical, paid counselling. It doesn’t mean that we’d exclude people, but last year, even though we put in a proviso that ACCEPT could only be a “first step” towards training, we found that some people would be bringing up issues of training and validation and accreditation. This distorts the training because the majority of people on our courses are nurses, teachers, social workers, religious, personnel managers, community people. In short, people who are in a job of counselling whether we like it or whether the British Association of Counselling or the Irish Association of Counselling or anybody likes it or not. They’re in a counselling role. Now that raises all sorts of issues.

Voluntary Counselling

We train people who work with AIDS, cancer, rape, telephone helplines like Childline or Samaritans, and people who have no experience in either the theory or having been in therapy themselves. Many of them are very open people who don’t know whether counselling suits them or not, so they come along to ACCEPT as a “first step” and some of that particular group go on to train professionally. As you know, the number of training agencies now, compared to ten years ago, when I first started training people, has increased enormously, and it is easier to tell people to go off and do a training. We are now in a position to focus on community counselling because counselling has reached a stage where the distinction between clinical and community/ voluntary counselling can be drawn, and perhaps parallels and points of connection can also be made. One of the problems that this raises is about accreditation and validation. I can imagine therapists or counsellors coming to me and saying, “Are your people supervised in a voluntary agency or a community agency?” My answer is that, when we give them their diploma, we tell them that they should have some form of support and supervision. I can’t compel the nursing establishment or teachers or personnel managers into supervision.

HIV/AIDS Counselling

Normally we train people in a way that is non-person-specific and non-problem-specific. Our approach has been that it doesn’t matter whether you are involved in bereavement or marriage counselling or rape counselling or whatever, you need a set of skills and you will need to know quite a bit about personality theories and approaches to counselling and so on. Now the difficulty this raises is that there are key problem areas in society that are just not being addressed. HIV/AIDS is definitely one. There is no systematic training course at a community/voluntary level in Ireland or Northern Ireland. I feel that if we address some key problems like that then we may be meeting some specific needs in the community as distinct from some very general ones. So we are now breaking from our traditional role and we are going to target some specific problematic areas in our culture. We will also keep the generic community counselling courses going as well.

Counselling and Society

Ideologically speaking, I feel that in any society, if it doesn’t incorporate counselling in its actual structures of education, health and so on, the hurts in society and in our culture are going to be propagated and they’re not going to be stopped. Recently there’s a book I’ve come across entitled, A Hundred Years of Therapy and Society’s Getting Worse, and I think there’s a very interesting comment there that society doesn’t seem to be getting any better, but the number of problems and the number of approaches to counselling and therapy seem to be increasing all the time. Now there is a statement in there about therapy and about society. I’m not sure that the clinical approach answers it, nor am I certain that the community approach will answer it either. Both approaches must address the needs of society.

You are probably aware that there have been a lot of question marks about the value of counselling and therapy and one of the key criticisms Fay Weldon made about therapy and therapists was that they denied the com­munity and developed the cult of the self. I feel that in many ways, by targeting key problematic areas in the culture, we will be promoting counsel­ling in a much more acceptable way. Some of the key problem areas in our culture are denied by the clinicians because there isn’t a living in it. When people are really in a problematic situation, the clinical setting cannot respond. So while I appear sometimes to be very questioning about the role of therapy, I’m still very accepting of it, but I am aware that how therapists and counsellors perceive therapy and counselling can differ tremendously from how people in the community view it, and, in some ways, I’m trying to bridge that gap. The limits of what it can deliver in our society need to be understood. But meanwhile, there are people in hospitals and at schools who are suffering, perhaps even attempting suicide; people who are under trem­endous stress and trauma in the educational system and the guidance counsellors very often are not therapeutic counsellors. The emphasis in their training has been more on interview techniques, assessment, the points for third level and all of that. In fact, the guidance counsellors themselves have carried out a study which shows absolutely gargantuan problems in schools. The shift in our society means that the stable focus for many young people remains the school as distinct from the home, and that puts an enormous pressure on the teachers and on the guidance counsellors, both of whom have little or no training in therapeutic counselling. But when someone comes to them feeling suicidal, or a drug addict, or under tremendous stress or what­ever, they can’t tell them to go off to a private therapist. Historically, from my own background, I feel so rooted in the community approach because I worked in schools and I realized that having case conferences and setting up massively expensive procedures for referral could not ultimately work for so many people. The disturbance in our culture seems to be reflected in the schools and other institutions, including marriage and the family. These community institutions are where my heart really lies. Here we are talking about counselling in a reality testing situation.

But the fact that we get so many applicants and have so many people on the course shows that there are an enormous number of people who simply want to be able to do their jobs a little better. If one were to impose super­vision and accreditation on them, we would be likely to frighten those people off. If counselling becomes over-regulated, there would be a huge problem about people who do crisis counselling or voluntary counselling – are they not to be recognised? Besides, you may find voluntary counsellors, but you’re not going to get many voluntary supervisors. What I’m really saying here is that we are in a quandary – if we have a very over-regulated structure, then we end up like America where psychoanalysts became at one with the medical and psychiatric establishment, a closed shop and a very nasty shop as well – but Ireland is at a transitional stage here. If we don’t get the balance right between delivering counselling in the community and delivering it in a professional capacity, then the Government may step in. Wouldn’t it be a ghast­ly prospect if the Department of Health or the Department of Education were to lay down criteria for counselling?

At the moment, however, the system of self-regulation is far from adequate. In some cases, distinctions between counselling and therapy are being abused and exploited, not in the interests of clients and the community, but to gain power and financial reward. I hope the next ten years will see a much more coherent and responsible response to the needs of our much – fractured society.

Interview by Mary Montaut