“A BBC survey found that 75% of married couples with children had at some point experienced serious problems in their marriage; of those, only 8% had sought counselling. Often, by the time couples seek help, their relationship is already in its death throes.” Guardian News & Media (2019). The article where I read this quote was an interesting read if these percentages were correct, how were organisations and charities such as Relate funding themselves in order to provide this much-needed service.
Relate is a charity that I also volunteered for during my first year with the Iron Mill. Last year my duties based mainly around receptionist, meet and greet responsibilities, and general administrative duties. This year I decided to do something a little more in depth during my time there. I wanted to see whether I could make a difference within Relate and one of its most important procedures in gaining funding. Relate offer counselling and/or psychotherapy predominately to couples and families in need. Although Relate national focus on relationship and family therapy, Relate Exeter also offer to counsel individuals and use specialist therapies such as sex therapy. There are eight counsellors currently working at Relate in Exeter, all of whom have to undergo Relate training, this can take up to four years in the more specialist therapies, such as psychosexual therapies.
Relate Exeter not only offer a range of counsellors, using a variety of different approaches, they can also offer discounted sessions to those in financial difficulty. This, of course, leads to high demand for couples, families and individuals seeking help and support.
I decided that for my research project I would have a look through Relates outcome/completion questionnaires and look into how and why they are used, the benefits of using them and the negatives that could crop up from using these types of assessment forms. I decided that to gain a deeper understanding of how Relate operates, my best resources were those already working within the organisation. Part of this process was to interview the counsellors currently working through the organisation, and the Devon and Cornwall area manager at Relate in Exeter to gain a little background into how much the forms are actually used, and whether or not they find advantages in using them for increased funding and/or counselling practice within the organisation.
Relate Exeter, which is now under the Relate National umbrella, is funded primarily through charitable donations, paid sessions with clients and funding that is predominately gained from data collected from such forms as the outcome forms completed by clients at the midway and at end of their sessions with Relate.
Thus, showing how important it is for Relate to collect as much information from sessions as possible in the hope to keep their funding.
According to Relate (2019), 150″,000 couples are having counselling with Relate each year. This shows just how many people (and this, just with Relate) are in need of couples counselling. How does this affect their funding? “Relate say their success rates are good – a study from the Newcastle Centre for Family Studies found 58% of Relate clients felt that their relationship was better one year after counselling.’’ Guardian News & Media (2019).
Relates largest client group that contact the charity for sessions are those in relationships that are struggling or those in family breakdowns. This not being surprising as Relate (2007) is fundamentally based around relationship and family therapy. However, Relate Exeter also offer individual and specialist therapy sessions for those who contact them in need. This is where my research project idea began to ignite.
After a little investigation into the different types of forms used, I realised that some of the Relate completion forms could do with a little ‘updating’. I discovered that the completed forms that are currently being used by Relate (Exeter) are solely for couples/families using the service for counselling, although Relate also offers counselling for individuals, sex therapy and young people’s counselling, the outcomes for these sessions are not currently recorded. I felt that for a charity that relies so heavily upon charitable funding and outcome-based funding, any additional data that showed Relate positively affecting those who used the service could be of great help.
This led me on to thinking about how I could fill this potential gap in data with my WBL project. I decided to have a go at creating a draft outcome/completion form for those in, or completing individual therapy and/or specialist therapy with their counsellor at Relate.
My first port of call was to have a chat with a couple of the therapists that are currently working at Relate. I put together a series of questions regarding what their thoughts are with using such forms in their practice, whether they find these forms useful, whether more specific forms for individuals would be useful and what they would include on the forms if they had the option.
Interestingly, their responses were mixed when it came to using the completion forms and their thoughts towards their usefulness. I asked one counsellor ‘How useful do find using these forms’ – Their response, ‘Not very, the forms (if) used, tend to be uploaded onto the system and forgotten about. This tended to be a theme with questions surrounding how it felt using the forms during sessions, and whether or not they were ever looked back upon if needed.
I decided to start working on a draft and asked another counsellor ‘What would you include on the forms if you could add anything?’. This sparked a little more enthusiasm! Most of the counsellors felt that it could be helpful to include a little bit of the client’s process through counselling. Perhaps what they may have gained from sessions through Relate, I felt that this was quite appropriate too, therefore it went into the draft. As the BACP (2015) states, “we will make each client the primary focus of our attention and our work during our sessions together”. I wondered myself, how filling out such forms during and at the completion of sessions may feel for the client. I liked the idea of making the forms a little more personal for both the client and for the counsellor/therapist, whilst still keeping the facts that were needed to show positive or negative outcomes.
Whilst interviewing some of the counsellors/employee’s at Relate Exeter, I also felt it important to discuss supervision requirements under Relates own ethical framework.
(Relate used to follow the guidelines within the BACP Ethical Framework, but since Relate Exeter has become part of Relate National, they have now adopted a slightly different Ethical Framework provided by Relate National).
My understanding of the importance of supervision has grown significantly during this foundation degree, and especially after starting my placement. The BACP (2015: p. 11 – 50) ethical framework states that “supervision is essential to how practitioners sustain good practice”, and as a student counsellor just starting out, I feel that my supervision has enabled me to grow a deeper understanding around my trigger points, my awareness over any transference that may occur during sessions, and ultimately reinforces my work with my clients in a positive and constructive manner. Bond (2015).
I asked the counsellors whether they ever looked back over the forms once completed, perhaps to see what progress was made, if any. This led me to my own wonderings of the usefulness of such forms for the counsellors working within Relate. Do the forms contribute to their own needs for supervision. Do the forms serve in rewarding counsellors a ‘pat on the back’ for their work? Do they feel pressure in using such forms and having to gain good feedback in order for Relates funding to be granted? ‘’For the Relate counsellor, the pressure is on because the government only wants to fund counselling for couples if it can be shown to work.’’ Guardian News & Media (2019). Was this true for any of the counsellors in practice at Relate?
The answers surprised me slightly. For the majority, it was a ‘no’ all round. Once completed it seemed the forms were uploaded onto Penelope (The software used at Relate), and seemingly forgotten about. Again, the question came to me as to whether the forms were too ‘cold’, just another form to fill etc. This led me to include a final question on my draft. “If comfortable to do so, please could you write a few words about your own process during your experience with Relate”.
After gaining all the information (interrogating) as many counsellors as I could, I started to put together my draft completion forms. I based a large amount of my draft around the current forms used at Relate for couples and families using the service. I felt that if I were to completely change the layout of the forms, it could be confusing for users, and perhaps overlooked completely as it wouldn’t correlate with the current procedure carried out.
Looking back over my experience, I think the most enjoyable part of my project was working alongside other counsellors in putting the forms together. I remember my feelings towards IAPT when learning about the NHS policies and procedures, and how I felt the forms felt so cold, compared to the sensitive nature of the work.
As the BACP (2019: p.1 – 3d) writes, “show respect by working in partnerships with clients.” It felt that by working alongside the counsellors at Relate, an element of the ethical framework was in-fact being played out in another kind of way. It was lovely for me, to be able to include some of the counsellor’s perspectives and questions when putting together the drafts.
Unfortunately, this is where my research drew to an abrupt halt. Big changes started to take place within Relate (Exeter) during my project, and it became increasingly difficult for me to be able to collect the much-needed data from those working there. It became very obvious to me and the others that the Area Manager was under new stress from something further up the chain of command. This meant that the small amount of time that I could ask for contributions towards my fact-finding mission and draft creation became non-existent. I managed to carry out a fair bit of at research at home, but I felt that I needed more first-hand experiences in order to finish my drafts. However, I didn’t feel that the experience had been a waste for me. Before starting this project, I had a real aversion towards using any such forms in my future practice, but after my conversations with those working at Relate, and my learnings through the Iron Mill I have grown a deeper understanding as to why such forms can be of real importance. Especially to such charities as Relate.
What I have learnt the most from this research project, has been that although I don’t have the most positive viewpoint on using outcome forms, IAPT, or the forms used by Relate, I do now understand that these such forms can be of real benefit to the organisations using them. I appreciate that with charities such as Relate, using outcome/completion forms can be hugely influential in gaining crucial information that leads to more funding for the charity. If not, the only source of data that is used to provide evidence that Relates services is, in fact, making a positive difference to the clients that use them.
On reflection, it was very difficult for me to draft these forms, as I felt no matter what I did they still appeared, stiff and cold to me. The very thing I wanted to change about outcome forms I have previously seen, kept creeping into my drafts of the new forms I wanted to create. I started to understand that in order to tick the boxes and get the information needed, it was difficult for the forms to be too personal to each individual. I started to understand that, although I didn’t like the way the forms were presented, they did serve a purpose, and without meeting that purpose, they wouldn’t be used for influencing the amount of funding that reached Relate. The only thing that I felt I could do to help increase the odds in Relates favour by creating an outcome’s form that had not yet been used, and by doing so could have a negative effect on the data collected. Another question arose for me, ‘How honest are these forms about the service provided?’.
I feel that no matter how I formed my draft, or how the forms may be used, my negativity towards the procedure of form filling just doesn’t sit well with me. Taking part in this research project itself gave me a stronger insight into why such policies and procedures are useful, but they did nothing in the way of changing my opinion in using them myself in private practice in the not so distant future.
In conclusion, I feel that by taking part in this project, not only have I had the opportunity to work alongside counsellors working within the biggest relationship therapy organisations in the UK, and gain a deeper understanding into what process’ take place within such an organisation. Although my experience putting together these draft forms didn’t quite live up to my expectations, I do feel that I have collected my own data in how using forms in my future practice may sit with me. Perhaps one day I will be able to send on my drafts to Relate and see whether they could be used to enable more data collection and in turn increase funding. Relate (2007) is a charity that will stay quite close to my heart, not only because it is proving to be of great help to over one hundred thousand couples in the United Kingdom, but also on a more personal level. I have gained new friendships with the counsellors at Relate, their input and knowledge have proven to be invaluable to me over the past two years of study.