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Workplace Pathway | Support to Workplace Clients – What Counsellors Should Know.

Workplace Pathway | Support to Workplace Clients – What Counsellors Should Know

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Policy and Key Information

Introduction

People make businesses successful. Whilst productivity and profit may be the business goal, it is the people who deliver success. Most individuals want to be treated fairly and do meaningful work with collaborative colleagues. Improving the work environment and looking after employee wellbeing is a partnership between the workplace and the individual where individuals identify their own roles and responsibilities. Clients who come to workplace counselling typically identify that 30-50% of their issues are linked to their employment. Counsellors, who support workplace clients, need to look at the broader context of the workplace and the impact of work on wellbeing as well as vice versa to optimise client outcomes.

Workplaces are facing their own difficulties from globalisation, competition, new practices in response to a world pandemic, increased automation, remote working challenges, changing legislation, flatter structures and changing work contracts – all of which impact on the employee experience of their work. Counselling in the workplace needs to take these wider changes and the businesses perspectives into account to support the client in their broader understanding of their situation so that they can make the changes that are needed.

There are some core principles that can make work rewarding, meaningful and prevent psychological harm which the counsellor should consider in their wider understanding of the client formulation of difficulties. Knowledge of the current business context and how the workplace and the individual can contribute and support psychological difficulties enables the counsellor to work collaboratively with the employee to reduce their distress. Likewise, an understanding of workplace expectations from the counselling engagement can help the counsellor navigate through possible tensions.

The aim of this document is to help counsellors identify the additional context requirements of supporting clients with issues in the workplace whether as an individual or as part of an employment assistance programme. Some example starter questions for the client are listed after each section.

1. What Employers Want from Counselling for their Staff

Employer expectations are shaped by their values and beliefs and their concern about staff health balanced against productivity and overall business success. Employers tend to focus on client satisfaction rates, client take-up rates, clinical benchmarking, individual psychosocial value and attitudes to work. In the longer term, they are interested in reducing sickness absence, increasing productivity, management of change and showing care to their staff.

The decision on data collection and what to share with the business is a key decision for the counselling service. Ethically, the central feature of preserving client confidentiality is only trumped by safeguarding concerns.

Example Prior Knowledge and Counsellor Questions for Clients
  • What is the stance of your counselling practice or service in relation to confidentiality?
  • What processes are in place to balance the needs of the client and the business employer?
  • How knowledgeable is your service/practice about the employer business goals and additional services such as Occupational health, workplace wellbeing groups, neurodiversity services and coaching? How can you find out or ask the client directly?
  • What is your understanding of the employer business HR policies and wellbeing strategy?
  • What do you understand about onward referrals?
  • What is your service’s position on safeguarding, data protection and consent to share information?
  • Do you have an employer business link to the counselling service?
  • How can confidentiality be preserved in a very small company?
  • Is there agreement on a cut-off for the number of sessions allowed for a client?
  • What are the criteria and processes for requesting more if agreed with the client that protect the client’s confidentiality? Or how do you signpost the client to additional resources or services?
2. Factors Related to Wellbeing at Work

Recent studies have considered individual and organisational factors together to guide employee and employer action to improve wellbeing at work. Researchers have assessed individual employees’ cognitive functioning (concentration, fatigue), motivation (career aspiration, engagement, competence), relationships with bosses and colleagues and self-reported physical and emotional health.

Other parameters looked at include stress factors at work including work overload, job autonomy and control, feedback at work, impact of physical workspace, the level of support available and wider factors such as equity and career outlook. Studies have researched oppressive cultures at work, the role of employee engagement, the quality of work and (more recently) job insecurity in a Covid and post-Covid world of cost cutting. Flexibility has become an ingredient in business survival during the Covid pandemic and an expectation of employees to cope with greater intensification of work in leaner work teams.

Whilst unemployment carries a significant risk for mental ill health, job insecurity is associated with a doubling of the risk of common mental illnesses. Relationships with others (particularly before the Covid pandemic) were often a very common stressor. If relationships were difficult with managers before the pandemic, job uncertainty means people are less likely to address difficulties in relationships now. Some people working remotely are more likely to ‘bottle-up’ worries resulting in deteriorating wellbeing but for others, increased social distancing can reduce the toxicity of difficult relationships and wellbeing can improve.

Counsellor Questions
  • What motivates you at work?
  • What do you want from your work life?
  • How busy are you in your work?
  • Is the work at the right level of difficulty/enough variety?
  • How much discretion do you have to do your job?
  • How supported do you feel?
  • How secure is your job?
  • Where are the biggest threats you face at work or at home that impacts work?
  • (If relevant) How does remote working impact your relationship with your work?
  • How do you manage work-life balance?
3. The Role of Engaging Work

For many people, work plays an essential part in their identity and belonging. People tend to define themselves by their work as a social reference point and retired people often describe themselves, ‘I used to be a …’. In previous studies, 86 per cent of people said they valued interesting work and 76 per cent rated a sense of accomplishment as important as, or exceeding, pay. Engagement with work is linked with increased levels of energy, dedication, experiencing a sense of significance, and enjoying absorbing work. Engaging work offers benefits to the employee and employer and conversely bored or disengaged staff perform less well.

Counsellors need to enquire about engagement and belonging at work as well as finding out what matters most to the client employee.

Counsellor Questions
  • What is your relationship to your work?
  • Tell me more about your work?
  • What is the best bit of your job/worst bit?
  • Where does your job fit into the business?
  • Which relationships at work are supportive/which relationships are difficult?
  • What are your hopes for your work/work-life?
  • How does formal and informal communication work in your company? Meetings, team communication, communication with supervisors etc?
4. Control Over Work

The level of control that an individual has over their work is a key factor for wellbeing and can vary from time to time. Zero hours contracts or casual work are examples of employment situations that might undermine control. These employees are more likely to be at the ‘beck and call’ of employers, with little routine or certainty about their work hours or their pay packet. When someone is exposed to a negative, uncontrollable circumstance, they may conclude that their efforts are unrelated to their outcomes and become resigned to the will of others and perceive themselves as helpless. Decline in wellbeing is likely to follow.

Some of these effects can be reduced by employers giving as much advance notice as possible of work hours, communicating change sensitively, taking time to consider an individual’s situation, and by ensuring that workers who may see themselves as under threat have access to support services. The business HR policies are a useful reference point to check that the client experience is the intended business policy.

Counsellor Questions
  • How much control do you have over your work?
  • In what aspects, are you least in control? Can you give me an example?
  • How can you take steps to increase your control over your work?
  • Where are the areas at work that you cannot control?
  • How does that make you feel?
  • Are there any ways that you can take steps to mitigate this effect?
5. Understanding the Business Context

The work context of counselling is recognised and explored to understand the client’s difficulties. Whilst much of counselling tends to prioritise the relationship with the client above all else, workplace counselling recognises that the contract is now a three-way agreement as the workplace is paying. That means directly or indirectly, that confidentiality and trust in the client relationship becomes more complex as well as more important. Contracting and agreeing confidentiality, its limits, the scope of note taking, the viability of reporting of anonymised counselling trends to businesses, clarifying consent to share with stakeholders, the design of referral systems – all impact how services are delivered and how clients will engage with counselling and the outcomes that can be achieved. Be prepared to experience tensions in this 3-way contract between your commitment to the client and the expectations of the business. On the whole, an open and transparent way of working is best where dilemmas are named, agreed processes followed and information is shared by consent to ensure the continued positive involvement of stakeholders to secure the client’s interests. The client always makes their own life decisions.

The business has an influence on take-up depending on their goals, how they promote counselling, the routes for referral and their attitude towards wellbeing and counselling services in general. Counsellors enquire how the client perceives the organisation’s relationship with the counselling service and their own positioning in this triad relationship. The counsellor finds a position that is respectful, curious and helpful from which to consider the role of the ‘other’ (namely, the employer, manager or colleagues) to support the client in moving forward.

The culture of organisations, the values of management and the processes and behaviour that embody those or deviate from stated positions are explored by the counsellor. That knowledge should not be based on personal or role experience but through curiosity and questioning to unpick the client’s understanding. As a result, both the client and the counsellor can grow in understanding of the real and perceived context of work and the kind of solutions that might fit that context as the work together continues.

Counsellor Questions
  • What is the main purpose of your employer business?
  • How is the company structured and what is the impact?
  • What does the future look like for your company?
  • What is your aspiration for work with this company or other?
  • What is the story told about your employer business by others/you?
  • How do you feel about working for your employer?
  • If your business was a person, what kind of person would it be?
  • What does your business say about itself that you do not think is matched by your experience?
6. Understanding the Business Resources and Networks

When the counsellor is assessing and formulating with a workplace client, there is a requirement to pay as much attention to the workplace community as to the family. Use examples to understand and unpick the relationships around work and recognise the roles and patterns of workplace power and politics. Equally important is the identification of other stakeholders and allies inside and outside the business that can be helpful e.g. professional associations, development communities, study groups, friendships in other offices or departments. It is helpful to strengthen support at and around work so work-life balance and boundaries at home can also be maintained, where appropriate.

Counsellor Questions
  • How and with whom do you spend your breaks?
  • Who likes to talk work with you in helpful way?
  • Who involves you with unhelpful conversations at work?
  • Who supports you most with work issues?
  • Who has influence at work and can be helpful?
  • Who is a role model for you at work and why?
  • What can you learn from role models?
7. Power in the Client Relationship

The employer business is of great importance as the third party in the psychological contracting process but power also flows and changes in the counselling relationship. The counselling referral process emphasises the presence of perceived power or its absence directly or indirectly e.g. reference to workplace status and titles to preface relationship or a perceived gratitude to the employer for enabling access when other options to help are out of financial reach. This positioning creates a lens to the relationship with work and a perspective on other aspects of life. As an example, a manager says of his low mood, ‘I should have the skills to cope better with this.’ The counsellor can work with the client to recognise how a workplace frame of him or herself as a ‘manager’ steers the language used and changes the options. By challenging the power dynamics and positioning, by using re-framing and re-languaging techniques, new meanings can appear.

Similarly, an employee in counselling, might describe being bullied at work and may be very submissive in the counselling relationship or dominating and challenging. The counsellor seeks (with the client) to understand how the workplace experience is impacting the therapy situation and draws out any perceived or actual contradiction between the organisation paying for counselling or an understanding of policy and practice short falls. It may be useful to view the situation through different organisational perspectives to tease out dimensions and patterns of power-play.

Sometimes the counsellor feels temporarily intimidated by the expertise, technical knowledge or status of a workplace client. Counsellors may struggle to understand the context and cut through ‘work jargon’ or ‘professional speak’. The client might use technical language or ‘prestige e.g. multi-million pound complex project’ to reinforce their own status and power in the counselling relationship, to act as barrier to exploration/ challenge or because trust has not yet fully developed to speak more personally. This could be the first time the client has had to tell a story of work and hear him/herself tell it, in which case it is not a barrier at all but a natural phase in the therapy.

Questions for the Counsellor
  • If you were not a ‘manager’, how would you describe your story with low mood?
  • What have you done as a person to manage your low mood?
  • How has your experience of being bullied at work informed our work together?
  • How does the company recognise blame or bullying?
  • When I hear you speak about ‘conservation- easement’ I feel baffled. What are you thinking/feeling when I say this?
  • I recognise your expertise in your arena and am interested in how this can help us move forward in our work in counselling?
  • How does describing these very technical work difficulties help you today?
  • What if we replaced’ consideration-easement’ with a catch-all-phrase like ‘the work problem’; how would it change how we spoke about it?
  • Who else knows about this problem?
  • When is it worse/better and with whom?
  • How does this problem impact you emotionally?
8. Management and Leadership

An effective management style can drive job satisfaction levels up to 2.5 times higher than a poor style. When employees are engaged, productivity is higher, staff turnover is lower (as much as 40 per cent) and accidents are less likely. Studies have shown that effective management styles positively impact on workers’ mental health which in turn may significantly influence the levels of performance and productivity. The benefits of coaching have potential not only to be reflected in organisational outcomes, but also in managers themselves. Various professional bodies have produced wellbeing charters and guidance to support employers in policy making and training of managers. It is sometimes helpful to have three-way conversations with managers with client consent to support the manager to help the employee. Alternatively plans can be made and shared with managers to support returns to work from absence but always with client consent and knowledge. The counsellor can also rehearse conversations with the employee to have with their manager.

Counsellor Questions
  • What are the things that are managed well at work?
  • What does your manager/supervisor do that is helpful/less helpful?
  • What policies guide your manager behaviour?
  • What affordances are provided within your policy framework to address your concerns?
  • How much of your manager/supervisor behaviour is endorsed by the business? E.G process and policy, more senior managers.
  • When do you notice this most? Who else notices this?
  • How do other colleagues manage this?
  • Who could support you in acting/responding differently?
  • What is the first step?
9. Towards a Systemic Understanding

Workplace counselling balances the importance of broadening the context of exploration into the layers of organisational life to over-complicating the counselling work.

All counselling evidence indicates that clinical outcomes are improved by the quality of the client and counsellor relationship, when the work is personalised and client-centred, when emotions are recognised and importantly, when there is a central tenet to the work with clear goals agreed with the client. These conditions are more significant than the modality we deploy. Research indicates that trained counsellors with access to clinical supervision are likely to determine the effectiveness of workplace services.

The context appreciation acts as a guide to assessment and formulation early on and later on, as a further interpretive framework to guide access a wider pool of bespoke solutions to improve the situation and embed the changes made. The art is in disassembling the contextual frame to distil the central tenet, to guide the work and not to confuse or overwhelm the client.

Counsellors use summarising regularly to locate themselves and the client in the work and monitor progress towards the agreed goals. The aim is to improve the client’s distress, increase their self -knowledge and information and explore the disentanglement of work and personal life so patterns are understood, and they can move forward positively and independently in future.

Counsellor Questions
  • How does your work’s loss of contracts (as a result of Covid) link with your situation at home?
  • Which ‘hat’ are you wearing as you say that ….’Manager’ or ‘husband’?
  • How does this conversation move you further to your goal?
  • How does working overtime impact on home and home impact on working overtime?
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