Counselling seniors

Thu 11 Aug 2011 03:14:00 PM EEST

In the UK, counselling is an umbrella term covering a range of talking therapies and is generally delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or enhance their wellbeing.

Counselling is often taken up as a second career where people develop an interest based on their experiences from within the helping professions, like teaching, nursing or social care, or as a result of their own life experiences(http://www.bacp.co.uk). This means that provision of counselling courses try to cater for people who need to work and train at the same time and are therefore mostly part-time, in the form of evening or day release. There are no legal minimum qualifications necessary to practise as a counsellor in the UK but there have been some moves to try and develop and improve the standards of counselling: a number of national bodies now exist which validate courses. Courses are generally aimed at people of working age and the current costs of courses may well exclude older people wishing to train as counsellors unless they are financially supported perhaps whilst working as volunteers in counselling settings.

Counselling roles

There are a number of paid employment or volunteering opportunities in the counselling field in different settings such as schools, further and higher education, health and social care. Outside of education, a great deal of provision comes from our diverse voluntary sector although many of these are now being undermined by reductions in expenditure in public services. The trend is towards providers of counselling being able to perform dual roles where counselling skills are used to deal with a very broad range of issues presented within a specialist area. There is also an emphasis towards peer counselling what we call 'expert by experience' where people using services or through community based organisations are seen as experts in their own issues and problems which can then be shared to benefit others.

There are some specialist services for older people within larger advocacy organisations particularly as older people tend to remain marginalised within more generic counselling services.

Need for older people's counselling

For education, training and career purposes, counselling in the UK is offered by the State through its 'Next Step' programme (Information, Advice and Guidance known as IAG). More recently, government reform (from 2012) aims to personalise further, how education and skills are provided. There is an acknowledgement that these should focus more on engaging disadvantaged people by giving more intensive support to those with the greatest need through the establishment of "an all-age careers service". What is unclear from this strategy, however, is the way in which this new service will cater for the specific needs of older people whose counselling requirements extend beyond career direction or the achievement of formal qualifications. Given that age discrimination is a topical issue in British society particularly since the Equality Act (2010) which attempts to address age discrimination in the UK, counselling is one area where there can be unintended consequences of ageism both within an education or community setting.

Support for life-course transitions through counselling

As a growing number of people spend more of their lives outside of the labour market, guidance for learning in later life needs to actively support life-course transitions, to enhance the quality of experience and wellbeing during ageing. Examples where guidance and counselling about learning for new roles are in relation to taking on significant caring roles, dealing with changes in health conditions, becoming a grandparent, or becoming dependent. Guidance and counselling that engages with the learning of older people could therefore become more orientated towards these developmental tasks.

Counselling services also need to consider issues such as where and how they are accessed, by addressing any obstacles such as decreased mobility and through greater outreach. Another problem is that learning guidance and counsellors may not be trained to work with older people even though it can be argued that older people have needs common to all other age groups. Exposure to older people during counselling training can be useful in challenging the stereotypes and attitudes of trainee counsellors in how they work with older people and enabling them to think about how their particular needs might be met.

On the pastoral side, the stereotyping of older people may require them to put up with issues or problems which might be otherwise amenable to counselling. Like every other stage of life, getting older has its specific challenges and there are a number of examples of discrimination against older people where counselling could offer alternatives and if younger, would have been referred to appropriate services. Current issues highlighting the needs of specialist counselling for older people as well as accessibility to mainstream services include:

  1. Responding to bereavement and loss given that for older people, this has a special poignancy where they may be least able to deal with the life-changing impacts that the death of a lifelong loved one can have and which can trigger a series of losses.
  2. The common use of antipsychotic medication particularly in care settings, to address depression and anxiety as opposed to offering 'talking therapies' and capitalising on the older person's own self-knowledge and skills.
  3. Missing out on the growth and opportunities of online counselling. For example, whilst online debt counselling grew by two-thirds in 2010, the charity Consumer Credit Counselling Services reported that only 3% of people using simple, anonymous and vital advice on how to solve their debt problems were aged 60 or over. Older people need support and help to use technology so they can engage in counselling to generate their own solutions.
  4. The Mental Capacity Act 2005 is a law which seeks to protect people who may not be able to make decisions for themselves because of dementia or other disabilities. The key principles of this act challenges previous paternalistic approaches and should include provision of independent advocacy or counselling to safeguard the older person's rights when making significant decisions about care, property and medical treatment for example.
  5. The specific cultural needs of older people such as gay and lesbian or people from minority ethnic groups or migrants require counselling services to be accessible and sensitive to their particular issues. Counselling training needs to incorporate how to work with their specific needs alongside the development of specialist training and provision.

Steps into the right direction

Participation, citizenship and person-centred services have been central to government policy in the UK and have attempted to capitalise on the empowerment of older people themselves and those that support them, individually and collectively to develop their own support networks. This is pertinent to both their learning and other support needs as these may become more integrated as people get older. The national evaluation of Partnerships for Older People's Projects (DH, 2010) demonstrated the sustainability of involving older people in developing community support, learning and the development of low-level preventative services which included alternative approaches to counselling by building on the older persons own capabilities. The Link Age Plus Pilot Programme (evaluated in 2009) was another attempt in the UK to coordinate a range of services in local authority areas to better help older people and perhaps meet some of these needs. The intention was to develop the concept of "one stop" information, advice and guidance services which would help older people with the range of issues for which they may have need of support. However there is no legacy of sustained services using the Link Age Plus principles and that link directly into education, training and career direction IAG services.

These are just a few of the examples of the issues and potential of counselling for older people in the UK. The British Association for Counselling and Psychotherapy (http://www.bacp.co.uk/) provides a directory of counsellors, and local Mind associations (http://www.mind.org.uk/) may also offer counselling

Text: InfoNet - Trish Hafford-Letchfield