that there is debate about which terms are/are not discriminatory). For example, we avoid any language that suggests that a particular difficulty defines the person – such as ‘depressive’. We also discuss the considerable and important debate about the use of medical language for mental health difficulties. The Time to Change campaign, which was set up to reduce the discrimination faced by people with mental health problems, provides guidelines on appropriate and inappropriate terminology (e.g. Time to Change, 2020). In line with this, we will be using the following terms in this book:
person with mental health problems or difficulties
service user
client.
These terms all have slightly different meanings; for example, ‘client’ tends to mean someone who is having counselling, whereas ‘service user’ is often used to describe someone who has a broader engagement with mental health services. All these terms will therefore be used, depending on the topic being discussed.
As an additional point, it is worth saying something here about how we are using the terms ‘counselling’ and ‘psychotherapy’. The distinction/overlap between these terms is hotly debated in some areas. In practice, the difference often (but not always) has something to do with the types of training people have. Psychotherapists typically undertake longer postgraduate training, while counsellors complete shorter, undergraduate/diploma training. For the sake of convenience we have decided to use both terms interchangeably. So when you read about ‘counselling’ and ‘counsellors’ this generally also includes ‘psychotherapy’ and ‘psychotherapists’ (and vice versa), unless stated otherwise.
Book themes
The aims of the book outlined above are reflected in the three principles that have informed the content:
Service-user and client voices: Acknowledging that service users and clients are the most important people to consider, and that they may have been harmed by mental health and counselling services, a key focus of the book is on the critical importance of listening to the perceptions, understandings and experiences of mental health service users and counselling and psychotherapy clients.
Diverse experiences: Understandings of mental health and assumptions about ‘best’ treatments have historically often disadvantaged, ignored or excluded minority groups. A second key theme of this book is thus around how diversity (e.g. in terms of ethnicity, sexuality and gender) impacts the understandings, expression and ‘treatment’ of mental health difficulties.
Research/methodology: A key concern of the book is how ‘knowledge’ about mental health and counselling is established. The book critically examines the strengths and weaknesses of underlying research approaches/paradigms and the limitations and caveats around the knowledge they produce.
Book structure
Understanding mental health and counselling is organised into five parts.
Part 1 Understanding mental health: the emergence of the talking cure
This part introduces the fundamental debates about the contested nature of mental ‘illness’ and the institutions that have developed to provide ‘treatment’.
Chapter 1 outlines the historical development of psychiatry and psychological treatments.
Chapter 2 introduces the service-user movement and outlines the concerted efforts of the people who have engaged with mental health systems to change them for the better.
Chapter 3 examines the evolution of psychological treatments and ‘talking cures’.
Chapter 4 focuses on the debates about systems of classification and diagnosis.
Part 2 Presenting problems
This part focuses on the issues that cause people to seek therapy.
Chapter 5 focuses on depression and anxiety.
Chapter 6 considers how trauma and crisis are understood and worked with.
Chapter 7 examines how our relationships influence our mental health and vice versa.
Chapter 8 presents an overview of formulation, presented as an alternative to diagnosis, and provides a prelude to models of counselling, which are covered in Part 3.
Part 3 Models of working
This part introduces some of the main approaches used in counselling and psychotherapy.
Chapter 9 introduces psychodynamic approaches.
Chapter 10 focuses on cognitive behavioural therapy approaches.
Chapter 11 introduces humanistic approaches.
Chapter 12 considers pluralistic/integrative approaches.
Part 4 Counselling in practice
This part examines issues central to how counselling and psychotherapy are practised and how mental health problems are treated in different practice settings.
Chapter 13 focuses on the therapeutic relationship in counselling and psychotherapy.
Chapter 14 introduces counselling approaches that go ‘beyond’ the individual.
Chapter 15 examines the rapidly developing field of technology-based counselling.
Chapter 16 explores professional and ethical concerns in practice.
Part 5 Contemporary issues: mental health and society
In this part, the focus returns to social understandings of mental health and how social, political and economic forces inform contemporary practice.
