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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.

       Chapter 17 examines how mental health and counselling research agendas and practices are often shaped by external forces.

       Chapter 18 considers the important links between ideas about mental disorder and criminal justice.

       Chapter 19 explores whether it can be helpful to think about mental health difficulties as societal versus individual problems.

       Chapter 20 reviews the debates about the idea that we now live in a ‘therapeutic culture’.

      The book ends with a conclusion drawing together these themes.

      Activities, reflections, readings and images

      We have included activities and ‘pause for reflections’ in each chapter. One aim of this is to help you reflect on your own understanding and opinion about the topics covered in the chapters. Another aim is to help you connect the material to your own experiences. Additionally, reflection – the ability to think about your thinking (and feelings) – is a key skill for counsellors, and so it is apposite to practise reflection in a book where the focus is mental health and counselling. We have also included suggestions for further readings at the end of each chapter.

      Finally, we hope that you will enjoy the artwork in this book. The cover image was created by Fatma Durmush, an artist represented by

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