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.


davidforster said...

That's very interesting. I've had some training in Coaching (rather than Counselling) methods - and been on the receiving end of them - which seem rather similar to NDC. But in the business or educational worlds coaches seem to be more willing to switch to a Mentoring mode - but would probably ask the client first whether that is what s/he wanted. What works for the client is more important than following a rigid model.

Catholic schools have this dilemma sometimes, when engaging Counsellors for pupils who need help. What is the moral stance of the counsellor? Will the advice be non-directive, or will the moral message be to the forefront? Since counselling is usually confidential, it's often difficult to know what is being delivered.

I wonder about the stance of an organization like the Samaritans. A friend who did the training as a listener a number of years ago told me that she didn't actually do the volunteering after all, because she disagreed with the organization's non-directive policy. I don't know how true that is - they have a good reputation for opening up alternatives for those who are suicidal. Is telling someone in that position "it's your choice, but talk through the options" more effective than a clear "don't do it" attitude? I just don't know.

Anonymous said...

Hello, I have read this twice, it's very useful. Just as if a person wants a definitive answer on ethics a good place to go to would be the Anscombe Ethics Centre, if one wants a definitive answer on non-directive counselling (NDC) the best place to go I think would be to several Counsellors per se (not just those you considered to be so for convenience, although useful and article very timely; the people with the most clear responses may've been rather say Spokeswomen for counselling organisations. And the subject can get quite detailed. From the little I studied of NDC (although this is not definitive) I read that counsellors CAN provide say practical information (although the book where I found this information wasn't considering pregnancy counselling where this practical side is more crucial I think). Moreover there are interventions I think even at the lowest level of training.
I'm still considering and thankful for consideration of the ethics side from the Anscombe.
One thing I'd say in general to help clarify to people in general re NDC is that neutrality is not an essential quality but is part of the role (I see it as their being bit like angels in not being able to tell people what to do but there supporting.)

By way I went to Samaritans office and spoke to a volunteer there about counselling and was shocked to see how neutral they can be; I explained to her, I remember, that I was Pro-life. I also felt sorry for them trying to help and yet...(words failing me at moment however i think it is known many volunteers become suicidal themselves).
What would help me as a Catholic re: abortion is the belief the child is in a "better place" (and this is known from the beginning somehow.)
I think what is possible in these situations can depend on the skill of the individial counsellor and most important would be the right attitude. (This would be worked on. Just as now I think I don't have quite the right attitude because I'm not so used to writing on blogs and not trying hard enough, not planning, and not praying except for this quick one : ) )

Ben Trovato said...

Very interesting indeed. DId you ask them about terminology at all? IE whether they would refer to 'the unborn child' (which might be construed as prejudiced in one way) or 'the foetus' (which I would read as prejudicial the other way) or avoid talking about it all together (which I would also find problematic)?