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Whilst the literature underpinning counselling psychology generally acknowledges that values and ethics are inherent in therapy1, the different ways in which they feature and to what effect are under-explored areas. Though therapeutic literature would seem to recommend that counselling psychologists take a critically reflexive approach to values and ethics, the extent to which counselling psychology training engenders this kind of thinking is unclear. This research project therefore set about examining the ways in which values and ethics were constructed in the talk of final year trainee counselling psychologists discussing values and ethics in counselling psychology training and practice. Four focus groups comprising a total of nineteen participants were conducted and transcribed. The transcripts were analysed using Willig’s (2008) six-stage approach to Foucauldian discourse analysis, identifying and exploring the ways in which participants constructed values and ethics in counselling psychology training and practice. The analysis examined the implications of the different constructions identified for counselling psychology training and practice and the subjective experience of counselling psychologists within these contexts. Three discursive constructions of values and two of ethics were identified, drawing on four discourses. The use of each discourse produced its own effects, offering participants different subject positions with different consequences for their therapy practice and subjective experience. The relationship between contrasting constructions of values and ethics from within an institutional and a humanistic discourse dominated discussion and appeared to have greatest impact on participants’ practice and subjectivity. Tensions were experienced between the differing demands of the institutional and humanistic discourses, resulting in feelings of dissonance and discomfort, as participants tried to mediate between contrasting constructions in an attempt to forge a coherent sense of identity and practice involving both.

This research explores how counselling psychologists construct of the diagnosis of ‘schizophrenia’ and their perceived ability to work with this client group. The diagnosis of ‘schizophrenia’ does not feature prominently in counselling psychology literature, and there is a distinct lack of empirical research pertaining to how counselling psychologist construct this diagnosis, as well as accounts of their experiences of working with this client group. The literature review commences with: an exploration of the context of counselling psychology with particular reference to theory, practice and research; the diagnosis of ‘schizophrenia’ in relation to the medical model debate; and, the implications of ‘schizophrenia’ for the theory and practice of counselling psychology, with a particular reference to diagnostic categories. A version of discourse analysis known as ‘critical discursive psychology’ is used to analyse how eight counselling psychologists talk about and around the diagnosis of ‘schizophrenia’ in semi-structured interviews. The analysis demonstrated a number of repertoires used in relation to the diagnosis of ‘schizophrenia’ and how these counselling psychologists use them in different ways. The analysis suggested that through the use of these repertoires the counselling psychologists negotiated their relationship with their clients, their ‘identity’ as counselling psychologists and the organisations they worked for. It was also found that there were a number of difficulties in their relation to the diagnosis of ‘schizophrenia’, such as how to negotiate the balance between phenomenology and empiricism, as well as the sometimes detrimental effects the institution had on the counselling psychologists. The research also raised questions concerning methodology and the use of critical discursive psychology in studying this topic, as well as issues regarding the conflicting epistemological positions of counselling psychology and critical discursive psychology.

In 1980, the various symptoms of combat stress were formally classified as post-traumatic stress disorder (PTSD), now an established condition with supporting research on its prevalence, possible causes and treatment options. As a diagnosis, however, it is marked by persistent questions about its validity as a conceptualisation of this group of symptoms. This kind of questioning stance is characteristic of counselling psychology as a discipline, which attempts to straddle both the scientific and therapeutic worlds of psychology. This latter, more subjective and interpretative world is currently absent from PTSD research and there is a consequent lack of understanding as to the perspective of those who have a PTSD diagnosis and who have undergone treatment for it. This research aims to fill this gap in the literature by asking veterans diagnosed with combat-related PTSD to describe and explore their experience of therapy. Six male participants were recruited on a voluntary basis from Combat Stress, the UK’s leading charity specialising in the care of veterans’ mental health. All participants served on a full time basis for the Armed Forces in a combat role and have since been diagnosed with combat-related PTSD by a Combat Stress psychiatrist. The data was collected using semi-structured interviews lasting around one hour. Analysis of the data was conducted using Interpretive Phenomenological Analysis (IPA), an inductive method which aims to explore and understand how a phenomenon is experienced from the perspective of those involved. Two master themes emerged, ‘being misunderstood’ and ‘developing understanding’, each with three subthemes. These themes explore these participants’ accounts of the internal confusion caused by PTSD symptoms and the external struggle to be understood by others and receive necessary help. These themes also engage with how the participants report a growing commitment to therapy, their developing relationships with themselves and their therapists, and the value of normative experiences in a safe environment. Together these themes form an interpretative answer to the research question: how do veterans diagnosed with combat-related PTSD experience therapy? The themes are explored in depth and links are drawn between them and the wider literature. The implications of this for counselling psychology practice are discussed, and suggestions for further research are made.