Counseling and Psychotherapy Transcripts, Client Narratives, and ...

Counseling and Psychotherapy
Transcripts, Client Narratives,
and Reference Works
A Resource for Mental Health
Educators and Practitioners
This white paper describes the nature and potential
uses of Counseling and Psychotherapy Transcripts,
Client Narratives, and Reference Works for training
in the helping professions. It provides information
on problems in counselor training and offers rich,
experience-based materials of actual sessions and
clients so that future and current counselors might
broaden and deepen their perspectives on the work of
helping. This database shows the power of modeling
for learning to become a counselor.
—Garrett J. McAuliffe, Ed.D., L.P.C.
University Professor
May 2008
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I. Overview
The work of preparing counselors is both important and fluid. Its importance lies in
the power that future counselors have over human lives. The fluidity lies in both the
constantly evolving theories and methods as well as in the nature of counseling
itself. Among the professions, counseling can seem like the most amorphous
(Skovholt & Ronnestqad, 2003). Counseling work is dynamic, with each client-
counselor contact being both an intentional and an impromptu encounter.
Counselors must remain both current and flexible to meet the evolving demands
of such a dynamic field. Texts and theories can age rapidly in that environment.
Resources must be rich, relevant, and current, if they are to be useful.
To respond to these demands for relevance and ongoing learning, SAGE
Publications and Alexander Street Press partner to create the database Counseling
and Psychotherapy Transcripts, Client Narratives, and Reference Works (CPTCNRW).
The database provides access to an evolving and expanding set of client narratives,
transcripts, and reference works that will be useful in the preparation of clinical
psychologists, clinical social workers, professional counselors, psychiatrists, and
psychiatric nurses, to name a few mental health professions that require rich and up-
to-date information. CPTCNRW combines conceptual material with rich anecdotal and
verbatim data.
Any training resource must be judged by at least two criteria: (1) usefulness and
(2) accessibility. Counseling and Psychotherapy Transcripts, Client Narratives, and
Reference Works meets both. CPTCNRW gives counselors and students of counseling
immediate entry to a storehouse of sessions, client stories, and theories that can be
integral to training programs and continuing education curricula. Through accessing
the materials in CPTCNRW, students and practicing counselors can discuss, analyze,
and discover the evolving nature of helping as expressed in the actual practices of the
past and present. The continuous updating of the materials ensures that diversity of
ideas, clients, and cultural issues is represented. This paper describes the content and
the potential of this new unique database product.
Thank you so much for putting this together! I cannot tell you how frequently I
have hoped to have such a resource available. I cannot commend your project
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enough, and I will be certain to subscribe once it is out.
—Alejandra Suarez, Ph.D.
Faculty of the Doctorate in Clinical Psychology (Psy.D.)
program at Antioch University, Seattle
“I find this initiative a wonderful opportunity for research, training and exchange
between academics and professionals, and I would like to congratulate SAGE
Publications and Alexander Street Press for carrying it forward. I have subscribed
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to the Preview Request and I am looking forward to take part in the initiative.”
—Felix Diaz
Psychology Lecturer
Universidad de Castilla-La Mancha (Spain)
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II. The Challenge of Providing Experience-Based Counselor Education
Counseling and psychotherapy are dynamic, interactive activities that allow for no
formulas. The mental health professional must therefore be prepared, through her
or his training, to make considered but immediate judgments in complex situations
with important consequences. Counselor education, like the work of counseling
itself, is an uncertain and complex enterprise. The work of counseling must be
taught at once experientially and conceptually.
Mental health practitioners have to weigh at least four factors at once in doing this
work: (1) a unique and evolving client conceptualization based on both individual
and cultural factors, (2) deliberately chosen theoretical lenses, (3) considered
moment-to-moment actions that are guided by a rationale, and (4) attention to
social systems that affect clients’ lives.
The major pedagogical challenges for the creation of effective professional
counselors might be summarized thus:
Challenge
Learning Tasks Required
Experience client narratives, see experts
conceptualize clients, know diagnostic
Making client conceptualizations
concepts, understand culture and cultural
alertness, try out conceptualizations,
get feedback and re-conceptualize
Know counseling theories, translate
theories into actions in specific
Applying counseling theory in action
situations, with rationale and
evaluation of effectiveness
Observe, understand, practice, reflect
Enacting helping interventions
on, analyze, and modify helping skills
Observe, analyze, critique, and
re-create organizational and other
Engaging in systemic
systemic interventions to prevent
thinking and advocacy
and ameliorate social problems
and to promote social equality
In sessions, a counselor must engage—do a mental dance in simultaneously
considering clients’ expressed and covert emotions, their mixed feelings and
contradictions, changes in client behavior within and between sessions, and the
counselor’s own responses to the client and the counselor her- or himself. To do
this work well requires “reflection-in-action” (Schon, 1987), that is, the ability to
weigh choices in the midst of a decision-making event. To promote that level of
professional sophistication, educators must have both (1) a guiding framework
for teaching and learning and (2) instructional resources and accompanying
technologies for stimulating learning. Each will be addressed in turn in this paper.
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III. Guiding Frameworks for Teaching and Learning in Counselor Education
At least two conceptual frameworks might guide the counselor educator who wishes
to produce complex professionals. One is experiential learning (Kolb, Boyatzis, &
Mainemelis, 2002). That theory outlines four modes that must be present for powerful
learning, namely (1) concrete experience, (2) reflective observation, (3) abstract
conceptualization, and (4) active experimentation. Counselor training should be infused
with all four. Another useful framework that can inform the training of counselors
comes from the social cognitive work of Bandura (2001). Social cognitive research
shows that individuals often acquire new behavior from observational learning, that is,
from watching the actions of others, especially credible role models.
Two themes run through both of these theories, namely the power of experience and
observation. Unfortunately, these two elements are difficult for educators to provide.
Instead, instructors often default to lecturing, and students rely on reading mostly
abstract conceptual material, in the form of counseling theories. Experience and
observation are often secondary in traditional counselor education, often saved for
the internship at the end of the program, leaving students poorly prepared to integrate
abstractions into coherent practices. Rich experience and observation must also be
provided early in training, and in an ongoing way, so that counselors can test abstract
conceptualizations in the fire of actual sessions and client stories.
Counselors-in-training must have models of best practices as well as of client
experiences. They must add conceptual understanding to active experimentation.
Counseling and Psychotherapy Transcripts, Client Narratives, and Reference Works
provides both anecdotal and conceptual material that is rich and current. These
resources can be used as texts in courses in diagnosis and treatment; abnormal
psychology; psychopathology; counseling and psychotherapy theories; social and
cultural issues in counseling; and counseling skills, to name some examples.
IV. Providing Effective Experience-Based Counselor Education: Solutions
Technology as an Asset for Counselor Education
Technology revolutions have occurred in counselor training. Following the original
technologies of film, audiotape, and videotape, digitized media have arrived as a
powerful, interactive means of teaching and learning the work of counseling. The
computer provides significant access to simulations, sessions, lectures, narratives,
and conceptual material—access that print and analog materials cannot. Through
the computer, client narratives and sessions can be captured and made available to
trainees and practitioners. With the use of the computer, instructors can have students
observe, reflect, and try concepts out in multiple locations and at many times.
CPTCNRW, a digitized database of counseling sessions, client stories, and conceptual
materials, provides this computerized resource. In CPTCNRW, extensive collections
of counseling sessions and client narratives are stored, indexed, and made available
to students in ways that previous media could not. And they are updated continually.
Given the power of experiential and observational learning for the craft of counseling,
sessions and client narratives must be made easily available to trainees for imitation
and analysis.
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Digitized Resources: Counseling and Psychotherapy Transcripts, Client
Narratives, and Reference Works
The digitized databank, CPTCNRW is comprised of the three types of materials
mentioned in its name. Each will be described here, with suggestions for use as well.
• Session Transcripts
These are explicit, word-by-word delineations of actual and training sessions.
A number of the sessions are conducted by leading theorists and model-
builders. Each session is preceded with titles that indicate counselor and client
demographics, client issues, and the counseling approaches represented in that
particular session. The sessions are generally offered in a straightforward manner,
with no introduction, ongoing commentary, or conclusion. Exceptions to that
model are the sessions that have been transcribed from DVDs and conference
presentations, which generally provide complementary narratives by the counselors
on the issues that the sessions provoke. Clients range in age, sexual orientation,
and ethnicity. Also included are group counseling transcripts. In addition, there are
sessions that explicitly demonstrate ethnic issues in counseling.
Client issues (in both sessions and client narratives) include both developmental
(e.g., identity, autonomy, career purpose) and non-developmental perspectives
(e.g., depression, eating disorders, self-injury) as well as the intersection between
the two frames. Those issues include the following:
eating disorders
depression (much emphasized)
schizophrenia (and its mysteries)
allergies (retraining the immune system using NLP)
conflict with family
self-injury
sexual dysfunction
indecision
substance abuse
social phobia
avoidant personality
distress over sexual orientation
histrionic personality
obsessive-compulsive disorder
panic, agoraphobia
developmental adjustment in young adulthood
anger
suicidality
insomnia
couples conflict/relationship dynamics
career purpose
conflict with family values
inauthenticity in interpersonal relationships
low confidence, low self-esteem
identity, autonomy
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Suggestions for Instructors. Instructors can supplement student understanding
by highlighting chosen elements in each selection. That would require instructors
to preview the sessions to construct their own understanding of them. The
sessions can be assigned to be read out of class, with suggestions that students
note their questions and comments on the moment-by-moment interactions. In
that way, students can both closely observe counselor-client interactions and be
actively engaged in raising uncertainties, questions, and critical comments. In fact,
instructors can prepare students for reading the sessions by providing a set of
questions that target client issues, culture, and counseling approaches. Students
might then read the transcript with the answers to these questions in mind, note
their responses as well as their own questions and comments, submit them
electronically to the instructor and/or the class, and then discuss them in a forum.
So that users might choose easily among the many selections, explanatory titles
and the information about the type of therapy, the year of the session, client gender,
client age range, client marital status, client sexual orientation, therapist gender,
therapist experience, and therapist education are provided at the beginning of each
session.
• Client Narratives
In this set of resources, clients tell their stories, usually in book-length form, about
their experience of distress and treatment, or mistreatment. Most of these narratives
are eloquently written by individuals who published their stories in book form. The
Client Narratives dimension of Counseling and Psychotherapy Transcripts, Client
Narratives, and Reference Works consists largely of digitizations of published
books by individuals who experienced emotional distress. The narratives, as of this
writing, range in time from about 1952 to the present, with an ongoing addition of
new material. Many of them provide a glimpse into both the phenomenal world of
distressed persons and into the systems that supposedly ameliorate such distress.
Clients represented in the narratives are both female and male, American and
British, African American and European American, heterosexual and gay, the famous
and the not-famous. The narratives include vivid accounts of the experience of the
following:

alcoholism
incest

eating disorders
family violence

depression
struggle over sexual orientation

schizophrenia
racism

bipolar disorder
hospitalization, both voluntary and involuntary
Client stories were written with two main purposes: to serve as models of recovery
for others who are in distress and to make a plea for more effective, human mental
health treatment. The stories are varied descriptions of triumph and hopelessness,
professional cynicism and positive engagement. There are inspiring tales of the
recovery and reclaiming of lives. Many of these writings are especially pointed
in their condemnation of inadequate and self-serving mental health institutions,
especially hospitals. Misdiagnosis and mistreatment are rife in the older narratives.
The narratives therefore demonstrate to future counselors both how to act and how
not to act as professionals.
The books from the earlier period are often calls for reform of what seems like
authoritarian and primitive mental health treatment. The evocations are sometimes
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of historical value (i.e., antiquated terms, conceptualizations, and intervention
methods are described). Electroshock therapy is described in a number of
narratives, as is the use and misuse of medications. However, the descriptions of
the anguish of the disorder itself are relevant to today.
A number of the client narratives are powerful polemical narratives (in book form)
about the primitive state of in-patient psychiatric practice from the 1940s through
the early 1970s. For example, one narrative declares
This book has been written for the express purpose of bringing to the American
people the facts about the parlous state of psychiatric research and training in a
country fat with prosperity, two-toned automobiles, and refrigerators which open
“
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from either side.
from “Every Other Bed”, by Mike Gorman, 1956, in Counseling and
Psychotherapy Transcripts, Client Narratives, and Reference Works
Clients tell their stories from the U.S. and from Britain in order to plea for a more
humane and effective practice. There are stories of both authoritarian, controlling
practice and stories of empathic, effective therapy. These narratives are testaments
to the overpowering presence and influence of psychiatry in mental health treatment
during most of the 20th century. They contrast to the late-20th century emergence
of the non-medical, and more egalitarian and inclusive, mental health professions of
counseling, social work, and psychology.
Many of the client narratives in Counseling and Psychotherapy Transcripts, Client
Narratives, and Reference Works are more contemporary and therefore even more
relevant to practice for trainees.
Suggestions for Instructors. The narratives that represent client experiences from
the 1940s through the 1970s can be assigned to groups of students as a means
of reminding them about misuse of power in the mental health fields and of the
limitations of mental health practice during that era when insight-oriented therapies
held sway and electroshock and medication were minimally effective and when
clients were often treated as powerless wards. The reader of the historical narratives
is reminded of the power of the humanistic and cognitive-behavioral revolutions,
of the patients’ rights movement, and of the advances in psychotropic medication.
This reading can serve the purpose of alerting future practitioners to never minimize
a client’s rights or treat clients in a dismissive fashion.
Reading any of the narratives, especially the contemporary accounts, can sensitize
future counselors to experiences that they may have little experience with. No
training program can introduce trainees to the whole range of human difficulties;
therefore, these glimpses into such issues as self-injury, family violence, and racism
may be the only vivid contact students get before entering practice. Such exposure
can make students more empathic and can increase their conceptual complexity in
dealing with the multiple issues of people in distress.
• Reference Works
These types of materials consist largely of whole-book handbooks of clinical
gerontology, parenting, narrative therapy, group counseling, family life education,
emotional and behavioral difficulties, parent-child relations, counseling women,
counseling men, Asian American psychology, and close relationships. Each is a
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complete, published work, usually an edited volume that has been reviewed for
publication. They are well-written by scholars. Some of them are the standard
reference works for those topics in the field.
Suggestions for Instructors. Students can read the material in the handbooks prior
to reading related sessions that might illustrate particular principles. While the
counseling sessions, client narratives, and handbooks are not cross-referenced,
instructors can construct a sequence by referring to the key terms that are listed at
the beginning of each entry and matching them with other materials.
V. Conclusion
Among professional fields, none depends more on a rich experiential foundation and
opportunities to reflect on clinical decisions and assessments of clients. This paper
has described a new and unique resource for the teaching of counseling. Counseling
and Psychotherapy Transcripts, Client Narratives, and Reference Works allows
students to analyze moment-to-moment interactions, scrutinize client dynamics,
and deepen their understanding of theoretical foundations. No longer will counselor
educators be dependent on scattered video materials and abstract print readings
to prepare future counselors to do this complex work. Students can now access, in
one digitized location, session transcripts, client narratives, and resource materials.
Counselor trainers can mine the rich store of actual counselor and client experience
that is represented in this collection. From these materials, they can generate clinical
decision-making questions, evoke discussion topics, and make student at-home
assignments. Counseling and Psychotherapy Transcripts, Client Narratives, and
Reference Works will provide, in one place the foundational material for many courses
and training venues. It will be an ongoing conversation-starter that will produce deeper,
more insightful counselors.
For more information about Counseling and Psychotherapy Transcripts, Client Narratives,
and Reference Works, please visit www.alexanderstreet.com/products/psyc.htm.
About SAGE Publications
SAGE is a leading international publisher of journals, books, and electronic media
for academic, educational, and professional markets. Since 1965, SAGE has helped
inform and educate a global community of scholars, practitioners, researchers, and
students spanning a wide range of subject areas including business, humanities, social
sciences, and science, technology, and medicine. A privately owned corporation,
SAGE has principal offices in Los Angeles, London, New Delhi, and Singapore.
www.sagepub.com
About Alexander Street Press
Since 2000, Alexander Street Press has been bringing together the skills of traditional
publishing, librarianship, and software development to create large-scale quality
electronic collections in the humanities and social sciences. Today, Alexander Street
Press offers more than 25 collections totaling many millions of pages, providing unique
resources for scholarship. http://www.alexanderstreet.com/
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References
Bandura, A. (2001). Social cognitive theory: An agentive perspective. Annual Review of
Psychology, 52, 1-26.
Gorman, M. (1956). THE REST OF THE REFERENCE SHOULD BE INCLUDED HERE
Kolb, D. A., Boyatzis, R., & Mainemelis, C., 2000, Prepared for R. J. Sternberg and and
L. F. Zhang (Eds.), Perspectives on cognitive learning, and thinking styles. Available at
http://www.learningfromexperience.com/research-library/.
Schon, D.A. (1987). Educating the reflective practitioner. San Francisco: Jossey-Bass.
Skovholt, T. M., & Rønnestad, M. H. (2003). Struggles of the novice counselor and
therapist.
Journal of Career Development, 30, pp. 45-58.
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