Wednesday, November 02, 2011

Non-Directive Counselling: what I have learnt

Last evening I presented one of two papers on NDC at a seminar on the subject organised by the Anscombe Centre, and took part in the discussion. I'm not going to give a blow-by-blow account of proceedings, or reveal the identities of anyone (I don't know if they'd mind or not), but I will sumarise what I think I learnt from a very interesting evening.

As the seminar was attended by a number of people from counselling organisations (or organisations which do counselling inter alia), as well as a number of moral philosophers, we were able to try in a sustained way to get to grips with each others' angles on the subject. The counsellors (as I might call them for convenience) were naturally not used to the kinds of questions we raised; nor were the philosophers especially well-informed about counselling. The first thing which emerged was that, as far as I could see, the existence of moral problems of the type we were raising had not occurred to the counsellors as a group before (or: before the thing blew up in the Catholic press a few months ago). Handling a counselling session to minimise cooperation with evil, or consent by silence to evil, was not part of their training. As Catholics they naturally had some instincts on these matters, but these things had never been formalised, and although they went into counselling with considerable professional training, ethics from a Catholic point of view did not form part of that. In this, of course, they are in the same boat as doctors, though one might have hoped for something better from organisations with strong links to the Church.

They were able to clarify for us some of the protocols they use and how these relate to the kinds of moral problem which I outlined. The answers to the question 'Can an NDC counsellor volunteer information?' and the question 'Can an NDC counsellor answer a question about his own moral view?' were both a clear 'no': nor would any of the counsellors present allow themselves to break the rules of NDC in an emergency situation.

On the other hand, some of them did say that they would aim to steer the conversation in particular directions, that they looked out for 'pro-life clues' and so on. If some kind of information would make a difference, in the counsellor's judgement, he would steer the client into asking for it.

This might look as though the rules of NDC were being kept in letter but not in spirit, but it also emerged that other organisations, including pro-abortion organisations, would regard the provision of information as not infringing NDC at all. Their approach would be to make sure that the client had a full set of options to consider. The pro-life counsellors would not set out options unasked: one reason for this which was discussed is that if you give pro-life options, it would seem that you had to give options involving abortion as well. Something a bit like a Socratic questioning method, of getting the client to see for herself, and to ask for herself the necessary questions, is used instead.

In addition to this, one counsellor pointed out that it would be impossible for a counsellor not to convey a certain amount about his own preferences by tone of voice, body language and so on. (Thinking about this afterwards, it occurred to me that this was much less the case with counselling over the phone.)

My argument in my paper was to the effect: NDC may well work in some cases, and indeed be the best approach in some cases, or for some of the time in a case, but a counsellor must be ready either to switch into a more interventionist mode of operating, or refer the client on to a more interventionist type of counselling, if the counsellor judges that a good outcome depends upon it. I pointed out in my paper that such a procedure was perfectly normal in ordinary counselling. However, the counsellors present were very resistant to this suggestion, and it is clearly not a way of doing things they are used to.

They used two arguments against it. One was that becoming more interventionist would undermine the rapport with the client. If this were true then it would never bring about a better outcome; but equally if it were true then other counselling organisations, who tell their counsellors to switch into a more interventionist mode when the client is suicidal, would have noticed. And indeed if being interventionist never worked then all the other kinds of therapy, other than NDC, would never work, and that seems rather an extravagant claim.

The other is that any deviation from NDC would be found out and referrals from GPs and the like would dry up. In the case of one counselling group represented at the meeting at least, the organisation's business model depends on strict adherence to the rules for this reason. Against this it should be pointed out that there are other business models: you can advertise and get your clients that way, and non-NDC pro-life counselling groups do just that. More fundamentally, this argument does not look to me like a justification for close material cooperation in a grave evil.

My preliminary conclusion from the discussion is this. One the one hand, despite saying they would never break the NDC rules, and their reluctance to move the client on to other forms of counselling, pro-life NDC counsellors can find ways of getting the client to ask for necessary information, can steer the conversation in a pro-life direction, and so on: so there are more resources for ensuring a good outcome (and avoiding cooperation in evil) than might appear at first.

On the other hand, when push comes to shove, and in the admittedly unlikely case when a word in season would make all the difference, pro-life NDC counsellors will stick to a strict interpretation of the rules and remain silent. I have yet to see a sufficient moral justification for that, but no doubt the debate will continue.