Annex A > Chapter 16 - Support and Counselling > Introduction > Terminology
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Terminology
3 The Inquiry commissioned a background paper from Dr Charlotte Humphrey. [2] She sought to set out the needs for care which parents of children in acute healthcare settings, such as those receiving paediatric cardiac care, might have. She wrote:
`... "support" is defined as including all activities or arrangements within the health care environment which help meet the psychological and social needs of parents whose children are receiving care, whether or not they are specifically intended to fulfil this purpose. Support thus covers a wide range of issues from practical arrangements for parents to stay in hospital and help in their children's care to the giving of information, encouragement, advice and sympathy. ...
`Given this broad definition of support, it follows that anyone involved in the provision or organisation of care at an individual or institutional level may have a part to play in ensuring that parents' needs are provided for and taken into account. Support may also be provided from sources outside the healthcare setting including self-help groups or facilitator-led support groups.' [3]
`Within the broader framework of psychological and social support, counselling is the activity which occurs when a person (either regularly or temporarily in the role of counsellor) offers time, attention and respect to another person or persons to explore their feelings and concerns ...
`Counselling skills, such as listening, reflecting and conveying empathy, are not exclusive to the counsellor. Almost all healthcare professionals need such skills in the course of their interactions with patients, for example in giving information, clarifying treatment options and helping people adjust to new and sometimes unwelcome circumstances. The difference between these generic skills and those of a formally defined counsellor (or psychologist or psychotherapist) is that the latter is expected to have advanced training and qualifications in their field and is likely to approach the counselling process within a specific theoretical framework ...' [4]
4 Mrs Valerie Mandelson [5] defined `support' as being: `... listening skills, empathy, being alongside a person at a time of great emotional stress and distress', and `counselling' as:
`... something on a deeper level ... something that is more formal, that is something that is entered into with the person who is the parent or the family, or the client ...
`Bereavement counselling actually provides a means of expressing grief in a much deeper way, and working on some of the tasks of mourning, facing the reality of the loss, perhaps experiencing the pain of that loss, and working with families in adjusting to daily existence without a very much-loved child and all the stresses that that might bring in terms of family stress, marital stress, self-esteem; and I guess, working with families, helping them find future direction ...' [6]
5 In a letter to the Inquiry, Mrs Mandelson said:
`There is debate amongst counselling professionals as to how we can usefully distinguish between support and counselling. I feel that many service users would be unlikely to be able to tell if they had been "supported" or "counselled".' [7]
6 Mrs Vegoda told the Inquiry that by `support' she meant:
`I was with the parents when the child went into the catheter lab. When the child had actually gone in, if the parents wanted me to be around, I would come out with them, often take them back to my room and they were often upset. At that point I saw that as support, because I felt they just needed somebody with them. They often were in tears, they needed someone to make them a cup of tea, and I think that was pure support.' [8]
7 As for `counselling', Mrs Vegoda said:
`... counselling might come in, for example, if I met a family where the child had been newly diagnosed and the parents, for example, were saying things like, you know, "It is my fault" and "I feel very guilty", or they were very angry about the child having a condition. Then I would try and use my counselling skills, because I would try and help them to see that that was not so ... I felt the counselling was helping them to come to terms and accept what was normal, and also to deal with it.' [9]
8 Miss Stratton told the Inquiry:
`... my personal definition of counselling is someone who has a professional qualification to carry that out.' [10]
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Footnotes
[2] Charlotte Humphrey PhD, Professor of Health Care Evaluation, Florence Nightingale School of Nursing and Midwifery, King's College London, formerly Senior Lecturer in Sociology, Royal Free and University College Medical School, University College London: BRI Inquiry paper on support and counselling for parents of children in acute health care settings, December 1999, INQ 0025 0001 - 0023
[3] INQ 0025 0005; Dr Humphrey's paper
[4] INQ 0025 0005 - 0006 . Dr Humphrey also referred to a paper (Bor R, Miller R, Latz M, Salt H. `Counselling in Health Care Settings' (1998), London: Cassell) which identified four levels of counselling: information-giving, implications counselling, supportive counselling and psychotherapeutic counselling - and suggested that only the first two of these would routinely be provided by healthcare professionals responsible for patients' care
[5] Manager and Senior Counsellor, Alder Centre, Alder Hey Children's Hospital, Liverpool: Expert to the Inquiry on Support and Counselling Services and see later in this chapter
[7] INQ 0026 0008; letter to the Inquiry