Counselling in Primary Care Article3



The Future

One way to make these concepts useful to psychological therapists of all kinds is by the use of an assessment scale, which the client could complete at the start of therapy. The benefit of a psychometrically designed scale is that the different dimensions (ie ‘labelling’, ‘control of expression of emotion’ etc) can be measured and scored indicating the different strengths and weakness of the client’s emotional processing ability. If for instance prior to counselling an assessment indicated the client showed considerable confusion about labelling emotions the counsellor might choose to focus more on self-awareness and correct identification of what the client is actually feeling before trying to help them explore life stresses causing such feelings.

Apart from guiding the therapeutic process, it is important to measure the effectiveness of counselling. An emotional processing assessment filled in before and at the end of counselling allows the counsellor to assess changes in the way clients deal with their emotions. Helping the client explore and understand a particularly stressful situation is useful, but less important perhaps than helping them develop better ways of processing difficult life events which could help them withstand future crises. Counsellors need to know for instance, what emotional areas counselling benefits, so from both an individual client and from a clinical service perspective, an emotional processing assessment may have much to offer.

Where are we now?

Since the development of the model in 1990 whilst conducting psychological therapy with patients, in reading the psychological literature on emotions and from personal incidents in my own life, I have built a list of possible useful questions for an emotional processing scale and have explored different methods of recording and scoring emotional information.

In early 2000 the first version of the emotional processing scale (109 items) was constructed and given to consenting patients seen by counsellors and psychological therapists, ‘normal’ volunteers and patients waiting to see their GP, in total 150 individuals. Paper-based questionnaires were tested against computer based ones with short versus longer instructions, etc. so that we could test whether answers depended on the content rather than the mode of presentation. Participants were invited to comment on the questionnaire as a whole or any individual questions they found hard to answer. The questionnaires were scored and the qualitative and (mainly) quantitative data were examined. The psychometric statistical analyses we conducted examined questionnaire item distributions, internal reliability, split-half reliability, convergent-discriminant analysis and factor analysis.

The Future

A shorter improved 40 item ‘mark 2’ questionnaire has now been developed to provide (1) measures of frequency and strength of emotions (2) measures of control of the experience and expression of emotions, (3) ‘a way to measure’ the ability to label emotions and to link them with life events, (4) awareness of emotions and other key dimensions in emotional processing. The scale is now ready for use with various types of patients to explore their differing emotional processing abilities and deficits. The first group of studies involves patients who ‘somatise’ their psychological distress seen in medical settings. The second group of studies aims to explore the use of the assessment in other counselling and clinical psychology settings. As the scale is used in different medical and psychological settings, we hope to build up a greater understanding of emotional processing and be able to make further refinements for a final ‘mark 3’ version which we hope will be employed more widely in counselling, psychological and medical settings. The scale is designed to integrate both with person-centred and cognitive therapy approaches.


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Counselling and Emotional Processing Research Project

We would be pleased to hear from any counsellors and other psychological therapists who would like to collaborate in the research projects we plan.

Research Project 1 – Aims and Objectives

Improving counselling through the use of the EPS

We want to give the emotional processing scale to patients to complete at the start of counselling or psychological therapy. This would provide the counsellor with information on the emotional processing strengths and weaknesses of individual clients. We want to find out if this is useful to counsellors and to discover if it influences the way that issues are covered in therapy and if it affects the way in which therapy is offered. We also want to find out if it improves counsellors’ conceptualisation of their clients problems.

Research Project 2 – Aims and Objectives

Emotional processing changes during counselling

We want to give the emotional processing scale to clients at the start and the end of counselling/psychological therapy together with anxiety and depression scales previously used successfully to evaluate a counselling service and a psychology service (Baker et al 1993, 1996, 1998). We hope to discover which emotional dimensions improve during therapy and how this relates to improved mood. This would help any therapist who wishes to assess their own work or if a group of counsellors or service providers wished to audit a service.

If you are interested in participating in either or both of these research projects please write to:

The Counselling and Emotional Processing Research Project

Dorset Research & Development Support Unit
Cornelia House
Poole Hospital NHS Trust
Longfleet Road
Poole BH15 2JB

Tel: 01202 448489 Fax: 01202 448490 E-mail:

The projects will start in Spring 2001 and run for a year. Back up training, advice and literature will be provided.

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