Integrative Humanistic Counselling & Psychotherapy

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1 Integrative Humanistic Counselling & Psychotherapy Aileen Hackett (CNS Psychotherapy, North Lee Mental Health Services) Integrative Psychotherapy embraces an attitude towards the practice of psychotherapy that affirms the inherent value of each individual. It is a unifying psychotherapy that responds appropriately and effectively to the person at the affective, behavioral, cognitive, and physiological levels of functioning and addresses as well the spiritual dimension of life. The term "integrative" of Integrative Psychotherapy has a number of meanings. It refers to the process of integrating the personality: taking disowned, unaware, or unresolved aspects of the self and making them part of a cohesive personality, reducing the use of defense mechanisms that inhibit spontaneity and limit flexibility in problem solving, health maintenance, and relating to people, and re-engaging the world with full contact (Erskine et al, 1997). Integrative Psychotherapy also refers to the bringing together of the affective, cognitive, behavioral, and physiological systems within a person, with an awareness of the social and transpersonal aspects of the systems surrounding the person. These concepts are utilized within a perspective of human development in which each phase of life presents heightened developmental tasks, need sensitivities, crises, and opportunities for new learning (Erskine et al, 1997). Psychotherapy within North Lee Mental Health Services in accordance with National Institute for health and Clinical Excellence, (2004) delivers a discrete, usually time limited, psychological intervention, where the interventions will have a facilitative approach often with a strong focus on the therapeutic relationship, but which may also be structured and at times directive.

2 The Psychotherapy department of North Lee Mental Health is led and facilitated by Clinical Nurse Specialists (CNS) qualified and accredited in a variety of psychotherapies that take into account many views of human functioning. The service subscribes to various approaches, namely Person-centered, Gestalt, Transactional analysis, Psychodynamic, Object relations, Body-psychotherapies and Family systems, Behaviorist and Cognitive which are all considered within a dynamic systems perspective. The post of CNS in Psychotherapy is closely guided by the governing principles of the Scope of practice for Nursing and Midwifery (An Bord Altranais, 2000b). The scope of practice in Ireland is the range of roles, functions, responsibilities and activities which a registered nurse is educated, competent and has the authority to perform (An Bord Altranais, 2000b, p7) Our Client Group & Service Mental ill-health has a high prevalence. About one in four individuals will have mental health difficulties at some point in their lives (Department of Health and Children, 2006). Our service is aimed at adults in the community who are living with mental health problems or emotional difficulties/distress with both complex and non-complex mental health problems. The Service is operating from mental health day centres and primary care centres in the region. Aims of the Counselling & Psychotherapy Service Our aims are to provide a specialist service for those with complex and non-complex mental health problems in order to maximise each person s right to health and well-being.

3 Complex mental health and emotional difficulties involve two or more psychosocial components e.g. Forensic history, severe social deprivation or strong family history of suicide, history of sexual abuse and self-harm behaviours in addition to the presenting problems e.g. depression and anxiety. As a result the care becomes disproportionately more complex and difficult for the person or the health and social care system to manage. Less complex mental health difficulties include no more than one of the above named components in addition to the presenting symptoms. Aims: To treat each client with fairness, respect and dignity. To provide and participate in a collaborative process for treatment and change. To facilitate wholeness so that the quality of the person s being and functioning is maximized. To apply and utilise direct interventions by implementing evidence based practices to promote change, relieve client s psychological distress and promote recovery. To provide indirect intervention with the liaison and support of statutory and nonstatutory agencies relevant to the care of clients and support groups. To demonstrate and contribute to best practice by enhancing the quality of care. To build effective and rational policies, guidelines and protocols. To offer an early point of access to community services for early intervention. To provide choice of holistic care for the client.

4 Clinical guidelines for CNS (mental health counselling) practice Referral to Discharge Pathway Flow Chart Non complex cases CNS Counselling Referral Source Multi-Disciplinary Team meeting Out-Patients Department Community MH Nurses Day Hospital staff Psychology Department Social Work Occupational Therapy Home Based Crisis Team CNS Assessment & Screening Management Options: 1. CNS Counselling 2. Counselling Student Care Crisis Intervention 1. OPD 2. Acute Mental Health Service CNS Counselling Service Establishing appropriateness of referrals Comprehensive Assessment and History Taking Follow up appointment given for CNS service Decision made on therapy interventions required for goals, time frame, tasks and contracts discussed with client Referral to other Health Care agencies and Professionals Counselling Student Care Inclusion criteria: Treatment and management of non-complex cases Discharge Routes GP OPD Back to referer Other agency

5 References An Bord Altranais (2000a). Code of professional conduct for each nurse and midwife: April Dublin: An Bord Altranais. An Bord Altraniais (2000b). Scope of practice for nursing and midwifery. Dublin: An Bord Altranais. An Bord Altranais (2004). Framework for the establishment of Clinical Nurse/Midwife Specialist Posts: Intermediate pathway. Dublin: An Bord Altranais. Department of Health and Children (2006). Vision for change: Report of the Expert Group on Mental Health Policy. Dublin: The Stationery Office. Erskine, R.G. & Traumann, R.L. (1997). Therapies and methods of an integrative transactional analysis: A volume of selected articles. Transactional Analysis Press: San Francisco, CA. National Institute for Health and Clinical Excellence (NICE, 2004) Depression: Management of depression in primary and secondary care. Retrieved from

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