Day 4

Today was spent mainly trying to find more articles suitable for the literature review, reviewing the ones I had already selected to determine if they were relevant to the study, and to suss out what their findings were.

One thing I noticed was that for several of the studies, counselling is as effective as normal medicinal care in terms of helping patients cope with depression (i.e. their depression gets better), and that the important part of counselling was not so much the method or theory used but instead the way the counsellor conducted the sessions (i.e. the environment of the counselling and the person of the counsellor). This was especially interesting to me as I had always assumed that CBT would be the most effective therapy in terms of aiding depression, and that counselling would only be effective if medicine was involved. The thought of the possibility of replacing medication with counselling was quite mind-boggling, and I wonder if this would be culturally suitable to Singapore (where people believe so much more in medicine - although several people hate taking medication - than in counselling).

The idea that the theory behind counselling might not be as important to clients' progress was also interesting, because for decades psychologists and social workers and counsellors have debated about the strengths and limitations behind each theory and model, and which ones suited which cultures and problems/issues. Yet at the end of the day to the clients, this did not really seem to matter as much as the counsellor just being there to guide them through, and the quality of their relationship with the counsellor.

This started me thinking that perhaps the importance behind these models and theories (besides to help us understand the clients better and know how which areas to focus on in terms of therapy) is not as important to the clients, but rather more important to helping the counsellors and therapists themselves become more congruent in their identity as a therapist. By being able to explore the various models and theories, therapists are able to see which ones appeal to them and make sense with their own worldview and paradigms, that match their value and belief systems. This would allow them to choose the best model for them to work with, allowing them to be truly genuine and congruent as they conduct therapy and counselling with clients. By being able to align their self-identity with their identity as therapists, this allows them to conduct therapy as a "whole being", which would create a "smoother" foundation on which to build the client-therapist relationship.

Putting this aside, I am finding it increasingly difficult to find articles that relate specifically to counselling for the elderly. As one article observed, there are few research evaluations that focus on the elderly, and thus there is a gap in the research literature in this aspect of the field. Which I worry would cause problems for the literature review as I attempt to write it. In regards to finding literature for the other age groups to show the efficacy of counselling, that is not a problem. However finding one that would be culturally applicable to Singapore is proving a little difficult as well. This will be a challenge for me as I continue to source for articles that will firstly a) address the age group that is of primary importance, the elderly, and b) meet our necessity for culturally-appropriate research.

Am looking forward to the focus group at RSVP tomorrow! I understand that they are better educated - however I am not sure how much of an impact this will have on the information we will gather, or on the way they carry themselves (and where they place primary focus in terms of aging issues and counselling).