The Missing Piece: How Alternative Treatments Might Be the Key to Your Addiction Recovery

Hello everyone,

The following is an article by Kimberly Hayes.

This article is based upon Kimberly’s work and research on alternative recovery methods.

Kimberly is currently working on a book about when addicts should seek alternative addiction treatments…and when they should be avoided.

I hope you enjoy this article.


Each year, millions of Americans have to contend with addiction to drugs or alcohol. You never think that addiction will happen to you, until it does, and then who’s left to pick up the pieces. Everyone’s recovery story is unique. Sometimes you never lose that safety net of a family to catch you and help get your life back in order. Sometimes you are left alone, after addiction has created a rift between you and the people you love. Sometimes there is counseling, group meetings, traditional 12-step programs and on-campus rehabilitation.


Even after taking all of these steps to get life back in order, you can still feel incomplete and normalcy can seem so far away. Perhaps it’s time for you to consider alternative addiction treatments to help you find that missing piece. Here are a few treatment alternatives to help get your life back on track.


  • Sweating it Out


Addiction recovery can be found in a variety of places, one of which can be your local gym. You’ve probably been told many times how a healthy lifestyle can transform lives, and maybe even seen it firsthand in friends or family who started eating better foods, or began training for a marathon. Well, diet and exercise can benefit more than just people looking to shed a few pounds. In fact, many recovering addicts have rediscovered that putting an emphasis on their diet and fitness routine has done wonders for helping them get through the turbulence of addiction and find the silver lining in their life after drugs and alcohol.


Exercise on its own is known to reduce stress and anxiety, while eating better foods gives us more energy, and can improve our overall mood. Beyond the immediate effects of healthy living, you’ll also benefit from a more structured routine that balances your fitness with everyday life. After seeing and feeling the results of diet and exercise you might notice that piece you have been missing is finally filled, and you are finally back to living your best life.


  • Expressing Yourself


Another alternative that may supplement your current addiction treatment can be found on the page, or in the studio. Expression is a powerful form of release. It allows you to get all the thoughts and feelings that have been bottled up inside of you out and in the open air. This is why so many recovering addicts turn to the arts as an outlet for their troubles and past traumas.


When expressing yourself, there is no right or wrong way to go about it. Find a medium that speaks to you, be it painting, or singing, or dancing. Start investing in old hobbies like writing or drawing, and harness your emotions as you go about your work. You’ll feel a million times lighter once you’ve put what your feeling into something you made, and you might even discover something about yourself along the way.


  • Giving it Back


Another way you can assist your addiction recovery is by reaching out and giving yourself back to others. In the past few weeks or even months, you’ve spent a lot of time focused on yourself and your needs. Looking inwards is important to understand who we are and figuring out how to make ourselves better, but sometimes we need more. The answer lies in looking beyond ourselves.


Volunteering in the community is the logical next step for recovering addicts who have dealt with their own issues, and are in need of some perspective. Serving people in need is a great way to see the bigger picture and find a deeper meaning and purpose for your life now that you’ve overcome addiction. You may find that your experiences are not mistakes, but valuable lessons that you can pass on to others so that they can live fuller, happier lives and in the process you, too, will feel proud and satisfied.


These are just a few alternative treatment ideas. By choosing to quit giving in to your addiction, you’ve already proven that you have what it takes to fulfill your recovery. It’s not if you will find that missing piece, but when.


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I hope everyone enjoyed Kimberly’s article.

If you have any comments about this subject then you can post them in the comments section below.

We would be happy to hear from you.

Thanks everyone

Warm regards

Institute of Counselling

Write an article for our Journal

Hello everyone

Would you be interested in writing an article for the Institute of Counselling’s journal called The Living Document?

counselling therapy article writing
counselling therapy article writing

We are looking for people to contribute articles for publishing within our quarterly journal ‘The Living Document’.

We accept a wide variety of topics and subjects, with many of our previous contributions being focused within the areas of spirituality, personal reflection, personal development and counselling and therapy.


We do not require articles to be a certain length as we accept short articles for inclusion.


We adopt an open approach to publishing within our journal as we are more than happy to cover a wide range of topics and subject areas.

If you are interested in contributing an article for our journal you can contact us by email at


or by telephone at 0141 204 2230. We are located in Glasgow, Scotland.

We would be happy to hear from you.

Thanks everyone


Ian. Marketing Manager, Student Services


Alcohol Abuse And Domestic Violence (Part 2)

Hello Everyone,

Here is the second part of Alana Fraser’s article ‘Alcohol Abuse And Domestic Violence’. This article was originally published within the Institute of Counseling’s journal ‘The Living Document’.

Men, Women, Alcohol and Domestic Violence

It is a common stereotype that, in domestic violence, men are the abusers and women are the victims: but this is not always the case. Also, alcohol can play a
major role where women are abusing the men in their lives.

 For example, research indicates that in relationships where the male partner abuses alcohol, the woman may push, grab or slap the man out of frustration at the man’s continued substance use or relapse. Also, in couples where the female partner abuses alcohol, women report that, when intoxicated, they tend to argue and initiate physical aggression with their male partner(1). These crimes are typically reported less-most likely because of society’s views on sexual norms and stereotypes. It is a common view in our society that the man is the head of the household, and the dominant one in the relationship. Hence, it makes sense to think that a man might feel embarrassed to admit that his wife is abusing him:

“Incidents in which men abuse women are perceived more negatively than incidents in which women abuse men.”(2)

What the Research Shows

Dealing with domestic violence that is closely intertwined with alcohol consumption means dealing with two separate issues. This can make therapy a challenge.

In the past offenders have been asked to attend two different types of therapy groups: one for alcohol dependency and one for aggressive or violent behaviour. The relationship between the two has generally been missed, so the problem has not been dealt with properly.

One study(3), which addressed both issues together, took the form of a twelve step CBT group for alcohol dependent men with interpersonal violence issues. The men were divided between a Twelve Step Facilitation (TSF) group and a Cognitive Behavioural Substance Abuse Domestic Violence (SADV) group. The participants had been approved by the DSM as having alcohol dependency; they had also been arrested in the past year for domestic violence.

The SADV group concentrated on problem solving skills related to violence, awareness of anger, managing emotions, coping with alcohol cravings, dealing with feelings of loss of control, and emergency planning. The TSF group focused on better understanding both alcoholism and the recovery process, learning how to manage their negative feelings, developing an effective support system, and maintaining recovery.

Results showed that the SADV group experienced a reduction in both violent episodes and levels of substance abuse. Group therapy, here, was more effective as it focused on the relationship between alcohol consumption and domestic violence.

Another effective treatment approach is Behavioural Couples Therapy for Alcoholism and Drug Abuse. The purpose of this therapy is to improve relationship functioning and to create support for abstinence from alcohol and drug consumption.

In this form of treatment, the abuser participates in counselling and an Alcoholics Anonymous group. At the same time, their spouse participates in counselling and an Al-Anon group. This gives both individuals a chance to deal with the situation separately. The abuser is aided in learning how to effectively control their emotions and cravings. The spouse learns more about the nature of addictions. He/she also learns how to influence their partner in a way that is loving- but does not permit the use of alcohol or other substances. This approach is effective because each spouse learns what their roles and responsibilities are.

The Impact on the Family

 Domestic violence and an alcohol addiction are serious issues that can greatly affect, not only the couple, but the wider family, too. Also, domestic abuse is viewed as including a range of different levels of involvement. This varies from witnessing aggression and violence …to being caught up in a violent situation (for example, intervening to protect another family member) … through to being a direct victim of abuse(4).

Children often bear the negative effects of alcohol abuse and domestic violence by observing the abuse, being neglected, and by being abused themselves. Being under the influence of alcohol affects one’s ability to decipher responsibilities and what is, or is not, appropriate behaviour.


Thus, the intoxicated parent may leave their child unattended or neglected.

They may also emotionally, physically or sexually abuse the child. This is clear from the following statement:

“The parenting skills and behaviours of adults with alcohol problems are significantly impaired: they are frequently neglectful, abusive, unreliable, inconsistent and violent.”(5)

Furthermore, any kind of neglect or abuse can be detrimental to a child’s development. That is:

“The interplay between witnessing family violence, suffering child abuse, observing chemical dependency in a parent, and experiencing parental separation increases the likelihood that developmental problems will occur.”(6)

Children who experience abuse can develop low self-esteem, a lack of trust, feelings of helplessness, self-hatred, depression, anxiety, boundary issues, violent behaviour, and so on. They usually find it hard to manage these emotions – and the effects may continue into adulthood.

Indeed, abused children often become abusing parents. They then perpetuate the negative cycle of abuse. They may respond to their own children out of anger and rage as that was how their parents responded to them.

“In alcoholic and abusive homes behaviour may be very unpredictable or it may be rigid and very painfully predictable. The child may be perceived as intentionally frustrating his parent or as being bad and uncontrollable.”(7)

So, when a child resists control or starts to misbehave, a parent who was previously abused themselves may believe that their child is ‘doing it on purpose’. They then relate this purposeful, unpleasant behaviour to how their parents treated them in the past (intentionally causing them pain.)

This gives rise to angry feelings towards their child and, in response, the parent may become abusive.

Abuse is an emotionally devastating occurrence. It is provoked and intensified when alcohol is present. Both of these abuses can be extremely painful and devastating to a family.


Domestic violence is a serious issue that is significantly influenced by alcohol abuse. Alcohol consumption facilitates violence as it negatively impacts decision- making and cognitive functioning. This can have dire consequences for the person, their spouse and any children in the home.

When intoxicated, it is more difficult to think through the consequences of our actions. People act in ways that may be out of character as they lack control over their thoughts and behaviours. Specifically, while under the influence of alcohol, they may react emotionally instead of rationally.

Most therapy deals with the two issues (domestic violence and alcohol dependency) separately. This is usually ineffective as it ignores the connection between
alcohol and domestic violence. Research shows that a combined approach is more effective as offenders are taught to control their cravings, as well as their negative, destructive emotions.



(1)   O’Farrell, T. J. & Fals-Stewart, W. (2006). Behavioural couples therapy for alcoholism and drug abuse. New York: Guilford Press.

(2)   Seelau, S. & Seelau, E. (2005). Gender-role stereotypes and perceptions of heterosexual, gay and lesbian domestic violence. Journal of Family Violence, 20(6), 363-371.

(3)   Easton, C. J., Mandel, D. L., Hunkele, K. A., Nich, C., Rounsaville, B. J. & Carroll, K. M. (2007). A Cognitive Behavioral Therapy for alcohol-dependent domestic violence offenders: An integrated substance abuse- domestic violence treatment approach. American Journal on Addictions, 16(1), 24- 31.

(4)   Velleman, R., Templeton, L., Reuber, D., Klein, M. & Moesgen, D. (2008). Domestic abuse experienced by young people living in families with alcohol problems: results from a cross-European study. Child Abuse Review, 17(6), 387-409.

(5)   Velleman, R., Templeton, L., Reuber, D., Klein, M. & Moesgen, D. (2008). Domestic abuse experienced by young people living in families with alcohol problems: results from a cross-European study. Child Abuse Review, 17(6), 387-409.

(6)   Potter-Efron R. T. & Potter-Efron P. S. (1990). Aggression, family violence and chemical dependency. London: The Haworth Press.

(7)   Potter-Efron R. T. & Potter-Efron P. S. (1990). Aggression, family violence and chemical dependency. London: The Haworth Press.


Barnwell, S., Borders, A. & Earleywine, M. (2006). Alcohol-aggression expectancies and dispositional aggression moderate the relationship between alcohol consumption and alcohol-related violence. Aggressive Behavior, 32(6), 517-527.

Hittner, J. B. (2004). Alcohol use among American college students in relation to need for cognition and expectations of alcohol’s effects on cognition. Current Psychology, 23(2), 173-187.

McMurran, M. & Gilchrist, E. (2008). Anger control and alcohol use: Appropriate interventions for perpetrators of domestic violence? Psychology, Crime & Law, 14(2), 107-116.


I hope you enjoyed this article.

Please Like this article and leave any comments in the comments section below

Many thanks.

Best Wishes

Ian Morrison.   

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Grief & Bereavement Counselling Models Part 2

Hello Everyone,

This is the second part of the article about Grief and Bereavement Counselling Models from Neil Morrison. This article was published in the Institute of Counselling’s journal ‘The Living Document’ Spring 2010 edition. Please enjoy.

Murray Parkes moved from stages to phases and cycles, which were fluid in their construction. He worked with Bowlby (l6), the father of attachment theory, and so began to understand the dynamics of attachment and separation and the pain that this dynamic caused. Dr. Parkes presented a lecture to Cruse Bereavement Care (17) which included the following powerpoint slide:


(John Bowlby)


All social animals become attached to each other.

  • The main function of attachment is to provide security.
  • The function of crying and searching following separation is to provide reunion.
  • The nuclear source of security is the family.

The above illustration of social attachment shows how security, reunion and the family are all impacted by death and bereavement. That is, “the ideas that Colin Murray Parkes shared together go beyond description to propose an explanation, rooted in attachment theory, for the nature of complicated responses to bereavement. The thinking expounded here is destined to become part of the accepted fabric of those working in this field and will undoubtedly prompt continuing debate and further research.” The key word here is complicated – no matter whether it is ‘stages’, ‘cycles’ or ‘tasks’ of grieving and mourning.

Stages of Grief –


A Cyclical Model (ColinMurray Parkes)

 By describing different stages, Murray Parkes (18) implied that grief was a journey. It has various landmarks and the route will meander and change direction along the way. The final destination or end point of the journey is the healthy resolution of the loss.

Four stages are identified. These include:

1.     Shock versus Reality –

–         Characterised by numbness, denial and a sense of unreality.

2.  Protest versus Experience

–         Characterised by yearning and longing for what is lost.

3.  Disorganization versus Adjustment

–          Slowly realizing the full impact of the loss and finding a way of coming to terms with the changes death precipitates.

4.  Attachment versus Reorganization

–          Accepting that life has changed forever. Reattaching and forming new relationships. Establishing a new and fulfilling life separate from the deceased.

Colin Murray Parkes emphasized that these stages manifested in cycles which could reoccur during the grief journey.

William Worden – The Tasks of Mourning

William Worden (19) introduced the ‘Tasks of Mourning’. This not only observed what happened to grieving clients but was also proactive in that it suggested ‘tasks’ that clients could work through in order to facilitate the grieving experience. These are summarised below:

Task 1: To Accept the Reality of the Loss.

Task 2: To Work Through the Pain of Grief.

Task 3: To Adjust to the Environment in Which the Deceased is Missing.

Task 4: To Emotionally Relocate the Deceased and Move on With Life.

When a grieving client cannot work through each task successfully, they may experience complicated mourning.

This can be described as follows:

Task 1 not tackled: This is where the person does not acknowledge the reality of the loss.

Task 2 not tackled: This is where the person has not allowed himself or herself to experience the pain of grief.

Task 3 not tackled: This is where the bereaved person is unable to adjust to living without the person who has died.

Task 4 not tackled: This is where the person is unable to move on and does not, therefore, have the energy to adjust to the environment without the deceased(20),(21)Worden’s Task 4 has received some criticism, as is highlighted by the following quote from a University paper on ‘Holding on and letting go: The resolution of grief in relation to two Xhosarituals in South Africa’:

“While the dominant emphasis in contemporary bereavement literature is on the need for the bereaved to sever their ties with the deceased, this is not a straightforward issue … (It is possible that) some ties are not easily severed. Maintaining the polarity between the ‘holding on’ versus ‘letting go’ distinction is thus not always helpful, as this ignores the references within contemporary literature to holding on and disregards a multiplicity of meanings of what holding on and letting go entails”.

Worden himself has moved on from ‘letting go’ to ‘relocating’ the deceased in the mind of the bereaved. This is viewed as being a more humane way of counselling the person.


(16) Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

(17) w w w.crusebereavementcare .org ,uk

(18) Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

(19)        Worden, J.W (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

(20)        http://www.heron.nhs,uk




Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

http ://bjp .rcpsvch .org kubler ross five stagesof grief.htm

w w w.crusebereavementcare .org ,uk


I hope you enjoyed the second part of this article about Grief and Bereavement Counselling Models from Neil Morrison.

Please “Like and Share” it.

If you have any comments then you can post these in the comments section below.


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Grief & Bereavement Counselling Models Part 1.

Hello Everyone,


This is an article about Grief and Bereavement Counselling Models from Neil Morrison. This article was originally published in The Living Document Spring 2010. I hope you enjoy.


By Neil Morrison


Historically, counsellors will look to the work of Dr Elisabeth Kubler-Ross (13) the pioneer of support to personal trauma, grief and grieving, associated with death and dying. Her work dramatically improved the understanding and practices in relation to bereavement and hospice care.


Kubler-Ross’ ideas, notably the Five Stages of Grief Model (denial, anger, bargaining, depression, acceptance), are also transferable to personal change and emotional upset resulting from factors other than death and dying.


Dr. Kubler-Ross was at pains to stop practitioners thinking of her Five Stages of Grief Model as linear. However, it seems that this has been the thinking of many practitioners. (Worden (14), Parkes (15)). A common criticism was that not all clients come to the acceptance stage and may seem to be ‘stuck’ in the grieving experience at anger or depression. That was certainly my experience whilst in clinical training as a hospital chaplain. Many patients were stuck in their grieving experience and acceptance was by no means universal.


The concept that people in bereavement go through a grieving process is now also being challenged.

Is there a universal grieving process?

What seems to be developing is the view that people go through a grieving experience which is different for different people. This would, then, suggest that the Stages of Grief model is somewhat out of date.

Other theorists, while accepting the value of Dr. Kubler-Ross’ work, have moved on to phases and cycles, rather than stages, of the grieving experience (for example, Worden, Parkes and Ainsworth-Smith).

Russell Friedman and John W. James of The Grief Recovery Institute state: “We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to the ideas presented to them. After all, a griever is often in a very suggestible condition: dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred.


 Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rded). Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.


I hope you enjoyed the first part of this article. 

You can post your comments in the comments sections below.

Please Like and Share it.


Best Wishes

Ian Morrison               

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Alcohol Abuse and Domestic Violence

Hello Everyone,

 This is the first of two parts of Alana Fraser’s article Alcohol Abuse And Domestic Violence. This article was published originally in The Living Document edition Summer 2011. Please enjoy. The second part of this article will be posted soon.






Domestic violence is widespread today in Western society. There are many factors that contribute to abuse: one common influence being alcohol consumption. In a culture of high stress and increasing pressure, it is perhaps not surprising that many individuals turn to alcohol to alleviate the strain and the negative feelings they are struggling with. However, their decision to engage in substance abuse not only affects the person themselves, but it affects the people around them as well


Sadly, children are often the most vulnerable-and at the greatest risk- in these abusive situations. Also, observing or experiencing abuse as a child can lead to emotional and developmental issues. These can continue into adulthood.


Although there is no clear causal relationship between alcohol consumption and domestic violence, often alcohol abuse is  also reported in cases of spousal or child abuse. Furthermore, when the two co-exist, research indicates there is an increased frequency of domestic violence and an increased severity of injuries inflicted(1).


In terms of treatment, if the person can be helped to identify the relationship between their alcohol dependency and their violent behaviour, then counselling is shown to be more effective.


However, if the person does not understand the relationship between the two, they will have difficulties in controlling their negative and abusive behaviour.


Where Does the Responsibility Lie?


Substance abuse (including alcohol dependency) can lead to reactions that are out of character. For example, being under the influence of alcohol impairs one’s judgement, which can lead to harmful or negative behaviours. Also, an intoxicated person may find it hard to think through the consequences of their actions. However, although many may feel as if they have lost control and are not their true selves when intoxicated – this is not an excuse for abusive behaviour. This is summed up well in the following statement:


“From a cultural perspective, focusing on a perpetrator’s alcohol use can be criticized as permitting men to excuse their behaviour as driven by drink, thus providing a means of avoiding personal responsibility.”(2)


That is, instead of taking responsibility for one’s choices and actions, the responsibility for poor behaviour is being transferred from the person to the alcohol. Clearly, this type of attitude towards substance abuse is detrimental and erroneous. It is a kind of deception which allows the person to think that their behaviour is acceptable- regardless of the impact that it has on other people.


Effects on Thinking and Behaviour


Overconsumption of alcohol leads to an altered state of consciousness which, in turn, affects cognition and decision making skills:


“Research has shown that alcohol consumption affects our cognitive or thinking abilities. Types of cognitive abilities include, but are not limited to, attention, concentration, problem solving skills, and the ability to consider the consequences of our actions.”(3)


That is, alcohol consumption affects the way one thinks and reacts to situations and other people. For example, when a person is under the influence of alcohol they are less likely to think about consequences and may react spontaneously out of emotion.


In other situations, drunkenness can result in a feeling of excessive confidence or a boldness that translates to aggressive behaviours. This is why it is more common for domestic violence to occur when alcohol has been consumed.


A fight may start and, when the argument gets heated, the intoxicated spouse might overreact and hit out in frustration, anger or rage.


This is because they are responding from their feelings and are battling a sense of loss of control. The following statement illustrates this point:


“Individuals who consume alcohol respond to provocation with more aggression than do individuals who have not consumed alcohol.”(4)


From this, we may conclude that an intoxicated person, who feels provoked by their spouse or children, is more likely to respond in a violent way than a person who is sober and has greater self-control.



(1)   Velleman, R., Templeton, L., Reuber, D., Klein, M. & Moesgen, D. (2008). Domestic abuse experienced by young people living in families with alcohol problems: results from a cross-European study. Child Abuse Review, 17(6), 387-409.


(2)   McMurran, M. & Gilchrist, E. (2008). Anger control and alcohol use: Appropriate interventions for perpetrators of domestic violence? Psychology, Crime & Law, 14(2), 107-116.


(3)   Hittner, J. B. (2004). Alcohol use among American college students in relation to need for cognition and expectations of alcohol’s effects on cognition. Current Psychology, 23(2), 173-187.


(4)   Barnwell, S., Borders, A. & Earleywine, M. (2006). Alcohol-aggression expectancies and dispositional aggression moderate the relationship between alcohol consumption and alcohol-related violence. Aggressive Behavior, 32(6), 517-527.


I hope you enjoyed the first part of this article. 

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A students reflections on studying counselling skills

Hello everyone,

I would like to share an article with you today, the article is an excerpt taken from the Institute of Counselling’s Journal ‘The Living Document’.

This article was written by a former student of the Institute of Counselling.

The article details the students reflections and thoughts on studying counselling skills and how the process has enriched her understanding of her personal life.

I hope you enjoy.



This article traces my progress through my studies with the Institute of Counselling. However it does not primarily focus on what I have learned, the knowledge I have gained and the skills I have acquired. Rather, it discusses the challenges I have faced, and it charts how my experiences have informed my learning, and conversely how my learning has enriched my understanding of my own personal life.


I am a staff nurse working in a unit for people with severe dementia. In the words of our psychiatrist, it is essentially “a hospice for people with dementia”. It is where clients are referred when all other care options have been exhausted. Thus, I frequently provide end of life care. This was one of the reasons I decided to explore a course in grief and loss.


While researching this, I stumbled across the Institute of Counselling’s Graduate Diploma in Counselling Skills. I chose this course for a number of reasons …


First, it offered a module in Grief and Loss Counselling; second, it provided training at a higher level than my undergraduate degree; third, I have always had an interest in, and hoped to study counselling; and fourth, it included an element of pastoral counselling. This was important to me, as I am a practising Christian.


I commenced my studies in 2008.

During my first year, I studied two modules:

Foundation in Counselling Skills, and Grief and Bereavement Counselling Skills. On commencing the first module, I quickly realised that the essential qualities of Carl Rogers’[1] and Gerard Egan’s[2] approaches are those that underpin all elements of my nursing practice. These are genuineness, warmth and empathy. In fact, these qualities are the building blocks for all my relationships in life – both at work, and with my friends and family.


The second module focused on Grief and Bereavement Counselling Skills. Although the focus was on helping those who’ve lost a loved one, I found myself thinking more about how best to support families who were trying to make sense of this devastating illness, and the impact it was having on their lives. Indeed, many families grieve the loss of “the person they once knew” as dementia changes “the person they now are”.


I can identify with this sense of loss as my own much-loved grandma had dementia for five years. During that time, I witnessed her change from being a vibrant lady who loved to sing and dance to being a mere shadow of her former self, where she depended on others to meet her every need.


Gerard Egan’s model, ‘The Skilled Helper Model’ [1] was particularly relevant to my work as a nurse.


For example, when supporting loved ones I frequently find that the problems they present me with are not the core issues. This model helped me to explore and identify ‘what was really going on’ beneath the surface.


A case which illustrates this is a lady who was finding it hard to come to terms with her husband’s illness, and move him into long term care. By applying Egan’s model we were able to uncover that the key issue for her was actually guilt. Specifically, guilt that she had let her husband down, guilt that she had failed in her role as wife, and guilt that she could no longer cope with caring for her husband. Over time, she was able to work through these issues, using different counselling techniques and tools.


For example, we used Force-field Analysis to help the wife decide whether it was better for her to care for her husband at home or whether long term care would be more appropriate. This also helped her deal with her negative guilt feelings.


During my second year, I began to study Couple and Family Counselling Skills. This was a challenging module for me as both of my parents are alcoholics, and as a child I witnessed and experienced things that no child should see or experience.


Thus, studying the material highlighted my own need to address buried issues that I still needed to work through in an honest and open way. This was often very difficult for me. From a professional perspective, this experience showed me how important it is for a counsellor to work through issues that could interfere with the counselling process and relationship. That can help alleviate the likelihood of transference and counter- transference occurring.


When I started on this second module, I didn’t realise how useful it would be to my work as a nurse. I had viewed studying families as a means to an end: it was simply a module I had to complete to fulfil the requirements of my graduate diploma.


Although I frequently worked with my patients’ families, developing family and couple counselling skills seemed largely irrelevant to my job. However, I soon realised that my assumptions had been wrong, as studying a Family Systems Approach helped me better understand the dynamics within the family unit. This was reinforced by my research for an essay which detailed the benefits of using Systems Theory in the field of palliative care.


Studying this module proved to be challenging in other – unrelated- ways as well.


I suffer from severe asthma which is usually kept under reasonable control. However, during this time it became more problematic. I also developed polyarthalgia which was difficult to treat because of my asthma. In addition to this, I am a carer for a close friend. As her health deteriorated significantly, this increased the demands on me.


Although this was proving to be a very tough year, my module leader, Neil, was able to support me, so I managed to make it, and complete the work.

At present, I am working on the final module: Crisis and Trauma Counselling Skills. I have always found this area interesting. I am also aware that people facing crises have acute and serious needs.


In terms of my personal situation, shortly after commencing with my third year module I was admitted to hospital because of my asthma. There, my consultant gently shared that there was nothing more medicine could offer me. This was devastating news as I had always held out hope – but now that hope was gone. I returned home left to deal, in whatever way I could, with the impact that this news had had on me.


My consultant is excellent; however, I felt let down as there was a complete lack of emotional support in dealing with the news. I know my experience is not unique, and I really feel that counselling could offer a lot to people who are coping with a long term illness. Although the health service can offer us partial support, there is definitely a lack of holistic care.


On top of these concerns, a good friend passed away while I was preparing my first essay for the module. I felt heartbroken as the loss was sudden-yet many failed to understand the very real impact it had on me. To be honest, in some ways it felt silly as my friend was not a person: it was my guinea pig, Prince Harry. I had adopted this lad from a rescue centre. He was in terrible condition when I took him home – but he had thrived and blossomed into a cheeky little character. Hence, I was very attached to my pet. What made this so hard, even though he was in pain, was the guilt I experienced over ending his  .


The death of a much- loved pet is frequently underestimated and dismissed by many. As I prepared this article I spoke to several people who had lost their pets. All described it as a devastating experience, and one person likened it to ‘the loss of a limb’. Many described the same emotions as those associated with the loss of a human friend. However, they sensed few people understood how they felt, dismissing their grief as an overreaction. This is something that counsellors should note as often a strong bond of trust and love exists between a much loved pet and its owner. Hence, the loss of a pet can be devastating.


I am almost at the end of my studies now, and I can look back and say I have enjoyed it immensely. It has presented me with many intellectual challenges and life has added its own as well. It has certainly been hard work and has required me to juggle and prioritise my time and responsibilities. However, I have developed my skills and increased my knowledge.


I also believe I have grown as a person, and become much more confident. I am now considering my future options as I would like to move into an area of  work that is less demanding physically. That would accommodate my health issues-but also allow me to use my skills and knowledge to help other people in a meaningful way.


When I complete this course, I will embark on the Diploma in Youth Counselling. This should help me in my volunteer position as the children’s advocate in my church. I am sure this new course will bring further challenges, as well as new opportunities for developing my knowledge, skills and qualities as an individual and a counsellor.



[1] Egan, G. (2010). The skilled helper (9th Ed.). Pacific Grove, CA:


[2] Rogers, C.R. (1995). On becoming a person: A therapist’s view

of psychotherapy. Boston: Houghton Mifflin Co.


I hope you found this article interesting and insightful, remember you can let me know your thoughts in the comments below.

My next blog post will be posted in the next few days.


Best Wishes.


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